Predictive Surgical Reasons for Failure After Coracoid Process Transfers.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Shoulder reconstruction

Background:

• Recurrent anterior shoulder instability can occur after coracoid process transfer due to trauma, sports, or technical issues.
• Surgical techniques for coracoid transfer vary in graft orientation, positioning, and screw fixation.

Purpose of the Study:

• Identify surgical and patient factors linked to coracoid transfer failure, necessitating revision surgery.
• Hypothesize that single-screw fixation and graft malposition are common causes of failure.

Main Methods:

• Retrospective review of 83 patients undergoing Eden-Hybinette for recurrent instability after coracoid transfer (1977-2010).
• Analysis of demographic data, failure events, and physical exams.
• Radiographic review by two shoulder surgeons for graft positioning, nonunion, and hardware failure.

Main Results:

• 75% of patients experienced redislocation post-coracoid transfer; revisions occurred at a mean of 50.3 months.
• Recurrent instability predominantly affected males and often occurred during sports.
• Single-screw fixation and inferior graft malposition were the most frequent technical issues, correlating with higher hardware failure and nonunion rates.

Conclusions:

• Recurrent anterior shoulder instability post-coracoid transfer is more prevalent in young males participating in sports.
• Key technical errors leading to revision include inferior graft placement (below 5 o'clock) and single-screw fixation.