Cirugía de Latarjet-Bankart Artroscópico; Evaluación Tomográfica de la Posición del Bloque Óseo Primera Experiencia Chilena

Abstract

Introduction: Evaluate the feasibility and precision of arthroscopic Latarjet-Bankart surgery, using computed tomography. Describe outcomes and complications in the first prospective series of this technique in Chile.
Method: Fifteen patients underwent surgery using the arthroscopic Latarjet-Bankart technique. We evaluated the position of the coracoid graft by Computed Tomography, considering the following indices: screw angle - joint surface, excessively long screw incidence, joint line distance - graft edge in axial plane (tangent method), distance graft edge - joint surface (circle method) in axial and coronal planes, graft position relationship - glenoid diameter.
Results: A screw angle - surface 32.9 ° was obtained. In one patient a screw of excessive length (+ 4mm). According to the axial tangent method the distance was 0mm [0mm - 2.5mm], axial circle method 0mm [-0.8mm - 1mm], coronal circle 0mm [-1mm - 2mm], in 100% of the cases the graft position - glenoid diameter was under 50% or subequatorial. The graft was found in the “flush” position in all patients. In one patient was necessary to convert to open surgery. One patient with partial graft fracture. One patient had a major complication, which was a glenoid fracture and a transient plexitis of 5 weeks. Instability recurrence was observed in 13% of patients at 2 years follow-up.
Conclusion: It’s feasible to perform this technique arthroscopically, with a low conversion and complications rate, obtaining an optimal position of the graft.

Type study: Case Series.
Level of Evidence: IV