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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(06): e876-e884
DOI: 10.1055/s-0042-1751110
Artigo Original
Ombro e Cotovelo

Evaluation of Screws Positioning in Latarjet Surgery: Is There a Correlation between Parallelism to Glenoid and Radiographic Complications?*

Article in several languages: português | English
Eduardo Felipe Kin Ito Kawakami 
1   Médico radiologista do Departamento de Diagnóstico por Imagem, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
,
Gabriel Paris de Godoy 
2   Médico ortopedista e traumatologista da Disciplina de Medicina Esportiva - Grupo de Ombro e Cotovelo, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
,
Marcio T. Cohen 
3   Médico ortopedista e traumatologista do Grupo de Ombro e Cotovelo do Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil
,
Andre Fukunishi Yamada 
1   Médico radiologista do Departamento de Diagnóstico por Imagem, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
4   Médico radiologista do Hospital do Coração (HCOR), São Paulo, SP, Brasil
,
Geraldo R. Motta Filho 
3   Médico ortopedista e traumatologista do Grupo de Ombro e Cotovelo do Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil
,
Benno Ejnisman 
5   Chefe da Disciplina de Medicina Esportiva - Grupo de Ombro e Cotovelo, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
,
Paulo Santoro Belangero 
5   Chefe da Disciplina de Medicina Esportiva - Grupo de Ombro e Cotovelo, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
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Abstract

Objective To evaluate whether the parallelism of screws with glenoid in Latarjet surgery interferes in the positioning of the graft and to verify the reproducibility of a method of measuring screws positioning.

Methods Retrospective, multicenter study, of patients with anterior shoulder instability submitted to modified Latarjet surgery and at least one year of postoperative follow-up. Two radiologists analyzed the postoperative tomographic images, acquired in a database, to evaluate the positioning of screws and radiographic complications.

Results We evaluated 34 patients, aged between 21 and 60 years, one of them with bilateral shoulder involvement, totaling 35 shoulders evaluated. The tomographic evaluation of the inclination angles of the screws showed no difference between the observers. There was intra- and interobserver agreement to evaluate the following surgical parameters: graft position, presence or not of radiographic complications.

Conclusion The technique described for measuring the parallelism of screws in Latarjet surgery presented a very good and excellent intra-observer agreement, respectively. Screw parallelism with glenoid is recommended; however, it is not a mandatory and unique condition to avoid radiographic complications.

Keywords

bone screws - shoulder dislocation/surgery - shoulder joint/surgery - computed tomography x-ray

Authors' Contributions

Each author contributed individually and significantly to the development of this article. E. F. K. I. K.: conception, design and development of methodology, analysis, and interpretation of radiological data, writing and approval of the final manuscript. G. P. G.: conception, design and development of methodology, analysis and interpretation of data, surgery of cases performed at Universidade Federal de São Paulo (UNIFESP), writing and approval of the final manuscript. M. T. C.: development of the methodology, orthopedic surgery of cases performed at Instituto Nacional de Traumatologia e Ortopedia (INTO), review and approval of the final manuscript. A. F. Y.: conception, design, and development of methodology, analysis and interpretation of radiological data, approval of the final manuscript. G. R. M. T.: conception, design and development of the methodology, orthopedic surgery of cases performed at INTO, review and approval of the final manuscript. B. E.: conception, design and development of methodology, analysis and interpretation of data, surgery of cases performed at UNIFESP, approval of the final manuscript. P. S. B.: conception, design and development of methodology, analysis and interpretation of data, surgery of cases performed at UNIFESP, writing and approval of the final manuscript.


Financial Support

The authors state that they have not received financial support from public, commercial, or non-profit sources.


* Multicenter work, carried out in the premises of the discipline of sports medicine – shoulder and elbow group of the department of orthopedics and traumatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil and INTO (Instituto Nacional de Traumatologia e Ortopedia), Shoulder and Elbow Group, Rio de Janeiro – RJ, Brazil




Publication History

Received: 08 March 2022

Accepted: 19 May 2022

Article published online:
11 July 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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