Positioning of the Coracoid Graft in Latarjet-Patte Surgery. A Comparative Study Between Freehand and Guide-Assisted Techniques
DOI:
https://doi.org/10.63403/re.v33i1.464Keywords:
Shoulder instability, Latarjet-Patte procedure, Drill guide, Coracoid graft positioningAbstract
Introduction: the Latarjet-Patte technique is a commonly used procedure in patients with recurrent anterior shoulder instability and glenoid bone loss. Its success depends on accurate graft positioning and proper screw orientation.
Objectives: was to compare graft position and screw direction in the freehand Latarjet-Patte technique versus the guide-assisted technique.
Materials and methods: a prospective, comparative, randomized study was conducted between August 2021 and October 2023. Thirty-five patients (mean age 31.7 years) with an indication for Latarjet-Patte surgery were included. Seventeen patients underwent the freehand technique (group 1), and 18 underwent the guide-assisted technique (group 2). Postoperative evaluation was performed between weeks 4 and 6 using computed tomography, assessing graft position, the α angle, and the graft–glenoid contact angle.
Results: in the sagittal plane, 94% of grafts in group 1 were positioned adequately compared to 67% in group 2 (p = 0.042). In the axial plane, a “flush” position was more frequent in group 2 (72% vs. 53%), although this difference was not statically significant (p = 0.238). No significant differences were found in the α angle. Complete graft–glenoid contact was observed in 41% of cases in group 1 and 61% in group 2 (p = 0.477).
Conclusions: in this prospective randomized study, freehand and guide-assisted Latarjet Patte techniques demonstrated comparable results in coracoid graft positioning and screw orientation. The freehand technique achieved better sagittal plane positioning, while the guide-assisted technique showed improved axial graft contact, with no statistically significant differences between techniques.
Level of Evidence: I. Prospective Randomized Controlled Study
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