Primary bone graft stability after Latarjet surgery

• Verfasst von: Nolte, Anna-Katharina [VerfasserIn]
• Verfasst von: Bayer, Tobias [VerfasserIn]
• Verfasst von: Jäger, Sebastian [VerfasserIn]
• Verfasst von: Raiss, Patric [VerfasserIn]
• Verfasst von: Wegmann, Kilian [VerfasserIn]
• Verfasst von: Kretzer, Jan Philippe [VerfasserIn]
• Verfasst von: Bülhoff, Matthias [VerfasserIn]
• Verfasst von: Renkawitz, Tobias [VerfasserIn]
• Verfasst von: Panzram, Benjamin [VerfasserIn]
• Titel: Primary bone graft stability after Latarjet surgery
• Titelzusatz: biomechanical evaluation of a fixation technique with metal-free all-suture cerclage vs. cortical screws
• Verf.angabe: Anna-Katharina Nolte, Dr Med, Tobias Bayer, Cand Med,Sebastian Jäger, Dr Sc Hum, Patric Raiss, Prof Dr Med, Kilian Wegmann, Prof Dr Med, J. Philippe Kretzer, Prof Dr Sc Hum, Matthias Bülhoff, PD Dr Med, Tobias Renkawitz, Univ-Prof Dr Med Habil, Benjamin Panzram, PD Dr Med
• E-Jahr: 2024
• Jahr: April 2024
• Umfang: 10 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 29. August 2023, Artikelversion: 12. März 2024 ; Gesehen am 19.09.2024
• Titel Quelle: Enthalten in: Journal of shoulder and elbow surgery
• Ort Quelle: St. Louis, Mo. : Mosby, 1992
• Jahr Quelle: 2024
• Band/Heft Quelle: 33(2024), 4 vom: Apr., Seite e175-e184
• ISSN Quelle: 1532-6500
• DOI: doi:10.1016/j.jse.2023.07.032
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: biomechanical
• Sach-SW: FiberTape cerclage
• Sach-SW: Latarjet
• Sach-SW: metal-free Latarjet
• Sach-SW: primary graft stability
• Sach-SW: suture cerclage
• K10plus-PPN: 1902992210

Abstract

Background - To reduce hardware-related complications in coracoid graft fixation to the anterior aspect of the glenoid, a metal-free Latarjet technique was recently introduced. The aim of this study was to compare the primary stability of a classic Latarjet procedure with 2 metal screws to a novel metal-free, all-suture cerclage method. It is hypothesized that fixation of the coracoid graft with 2 malleolar screws will provide higher primary stability compared with an all-suture cerclage technique. - Methods - This biomechanical in vitro study was conducted on 12 fresh-frozen cadaveric shoulders (6 matched pairs) with a mean donor age of 80 years (range, 67-89 years). Coracoid graft fixation was performed using a recently introduced all-suture cerclage technique (group A) or a classic Latarjet technique with two 4.5-mm malleolar screws (group B). The conjoint tendon was loaded with a static force of 10 N to simulate the sling effect. Graft loading with a probe head consisted of 6 ascending load levels (10-50 N, 10-100 N, 10-150 N, 10-200 N, 10-250 N, and 10-300 N) with 100 cycles each at 1 Hz. Relative motion of the bone graft to the glenoid was measured using an optic 3-dimensional system. - Results - While loading the conjoint tendon with 10 N, no difference in mean displacement of the bone-graft was found between both groups (P = .144). During cyclic loading, a significant difference in relative displacement for both groups was already detected in load level 1 (group A: 2398.8 μm vs. group B: 125.7 μm; P = .024), and this trend continued with the following load levels (P < .05). - Discussion and Conclusion - The study demonstrated that the innovative metal-free, all-suture cerclage fixation technique results in higher micromotion than the classic coracoid graft fixation with 2 malleolar screws. According to the present biomechanical investigation, shoulders treated with a metal-free all-suture cerclage technique might need adapted rehabilitation protocols to protect the construct and allow for graft healing.