Coracoid process x-ray investigation before Latarjet procedure: a radioanatomic study

Area of Science:

• Orthopedic surgery
• Radiology
• Surgical planning

Background:

• Anterior shoulder instability often requires the Latarjet procedure for treatment.
• Accurate preoperative assessment of coracoid bone dimensions is crucial for successful Latarjet procedures.

Purpose of the Study:

• To evaluate if preoperative radiologic assessment of the coracoid process predicts the bone available for coracoid transfer during the Latarjet procedure.

Main Methods:

• Thirty-five patients undergoing the Latarjet procedure for anterior instability were assessed preoperatively using Bernageau and true anteroposterior (AP) radiographic views.
• Coracoid process length was measured on radiographs and compared to intraoperative bone block length.
• Statistical analysis included ANOVA and Wilcoxon tests.

Main Results:

• Mean coracoid process length was 29 ± 4 mm (Bernageau) and 33 ± 4 mm (true AP).
• Mean intraoperative bone block length was 21.6 ± 2.7 mm.
• A significant correlation (P = .032) was found between true AP view coracoid length and intraoperative bone block length.

Conclusions:

• Standard preoperative radiographs can reliably predict coracoid bone block size for the Latarjet procedure.
• This imaging method facilitates surgical planning, including graft orientation and screw placement, potentially avoiding CT scans.
• Preoperative measurements help identify anatomic variations and assess remaining coracoid bone in revision cases, possibly preventing iliac bone graft use.