Coracoid graft positioning in the Latarjet procedure

Area of Science:

• Orthopedic Surgery
• Radiology
• Medical Imaging

Background:

• The Latarjet procedure is crucial for shoulder stabilization, with coracoid graft placement directly impacting success.
• Accurate graft positioning is essential to prevent complications and ensure optimal functional outcomes.
• Standardized imaging analysis is needed to objectively evaluate graft placement post-surgery.

Purpose of the Study:

• To evaluate the intra-observer and inter-observer reproducibility of a novel standardized CT scan analysis for coracoid graft positioning in the axial plane.
• To assess the actual positioning of coracoid grafts in patients who underwent the Latarjet procedure.

Main Methods:

• A series of 27 patients (26.1 ± 6.4 years) underwent CT scans 2.4 ± 0.7 months post-Latarjet procedure.
• Osirix™ software was used for CT scan analysis, assessing graft relation to the glenoid and humeral head.
• Graft positions (lateral, congruent, flush, medial) were evaluated, with agreement measured using Kappa coefficients.

Main Results:

• Substantial to almost perfect intra-observer agreement was observed (Kappa: 0.64–0.81).
• Substantial to almost perfect inter-observer agreement was found (Kappa: 0.59–0.89).
• In the axial plane, 11% of grafts were lateral, 22% congruent, 60% flush, and 7% medial.

Conclusions:

• The developed standardized CT scan analysis accurately describes coracoid graft positioning in the axial plane.
• The method demonstrates good intra-observer and inter-observer reproducibility for Latarjet procedure assessment.
• This analysis provides a reliable tool for evaluating graft placement and guiding surgical technique.