Long-term minimum 5-year follow-up 3D CT evaluation of bone graft status after Latarjet in patients with no or minimal preoperative glenoid bone loss.

PURPOSE: The purpose of this study was to evaluate the Latarjet coracoid graft status using computed tomography (CT) at minimum 5-year follow-up in a population with less than 5% glenoid bone loss preoperatively. We hypothesized that complete graft lysis would occur in accordance with Wolff's law.

METHODS

This retrospective multicenter study included patients treated with an open Latarjet procedure across 8 centers who had less than 5% preoperative glenoid bone loss and available preoperative and follow-up CT scans. Glenoid bone defects were measured using the best-fit circle method on 2D CT. The preoperative glenoid articular surface was compared with the follow-up useful glenoid surface. Three-dimensional CT reconstructions with humeral head subtraction were analyzed to assess graft consolidation, resorption patterns, and screw coverage in sagittal, coronal, and anterior planes.

RESULTS

Thirty-four patients met the inclusion criteria, with a mean follow-up of 98.7 ± 32 months (range 60-172). Four patients experienced graft failure (1 fracture, 3 nonunions), resulting in a graft consolidation rate of 97%. Among the 30 patients with consolidated grafts, the mean useful glenoid surface increased by 1.28 ± 0.97 cm2 (P < .001), corresponding to a mean glenoid articular surface augmentation of 20.9 ± 23.9%. Three-dimensional CT reconstructions were available in 24 cases and demonstrated consistent graft resorption, predominantly affecting the superomedial aspect of the graft, with partial exposure of the superior screw in most cases.

CONCLUSION

At a mean follow-up of 8 years, the coracoid graft remained present in 97% of cases, even in patients with minimal preoperative glenoid bone loss (<5%). 2D CT showed a mean glenoid surface augmentation of 20.9%, while 3D analysis revealed consistent superomedial resorption. These findings demonstrate graft consolidation with a low complication rate, suggesting that the Latarjet procedure can be effective in this population.