2025 ISAKOS Biennial Congress Paper
Patterns Of Graft Resorption After Latarjet In Military Servicemembers
Scott Feeley, MD, Bethesda, MD UNITED STATES
Aidan McQuade, MS, Bethesda, Maryland UNITED STATES
Conor McCarthy, MD, Bethesda, MD UNITED STATES
Benjamin Hoyt, MD, Chicago, IL UNITED STATES
Daniel Lawrence Rodkey, MD, Bethesda, Maryland UNITED STATES
Kelly Kilcoyne, MD, Bethesda, MD UNITED STATES
Jon F. Dickens, MD, Bethesda, MD UNITED STATES
Walter Reed National Military Medical Center, Bethesda, MD, UNITED STATES
FDA Status Not Applicable
Summary
For Latarjets performed as the index bone block procedure, graft resorption at the superior screw was associated with less glenoid bone loss and smaller coracoid grafts, while inferior resorption was associated with clinical failure.
Abstract
Objective
Graft resorption following the Latarjet procedure is common, although underlying reasons are unclear. Graft remodeling may occur in accordance with Wolff’s Law or from osteolysis. Therefore, our aim was to characterize Latarjet graft remodeling and identify risk factors for resorption.
Methods
We retrospectively analyzed open Latarjet procedures in the military from 2010-2018. We excluded patients without computed tomography (CT) or two-year clinical follow-up. We included primary and revision Latarjets, but all were the index bone block procedure. Preoperative CT was analyzed for coracoid thickness and glenoid bone loss (GBL) and postoperative CT for graft positioning and the primary outcome of resorption by Zhu classification. Secondary outcomes included union, recurrent instability, and reoperation. We analyzed risk factors for resorption using contingency tables and t-tests.
Results
We identified 78 Latarjet procedures (31 primary, 47 revision). The overall cohort was 94.8% male with median age 24.0 years (IQR 21.6-29.3), GBL 22.7% (IQR 17.4-28.0), follow-up 6.4 years (IQR 4.1-9.4), 79.2% had GBL >15%, and 50% had major graft resorption.
For primary Latarjets, thicker grafts had less resorption at the superior screw in the axial (p=0.007) and sagittal planes (p=0.013). For revision Latarjets, lateralized graft position was associated with resorption (p=0.031), though there was no association between medial to lateral graft position and resorption in the overall cohort. Excess graft thickness beyond what would restore the perfect circle diameter was not associated with amount of resorption.
The amount of resorption at the superior screw was significantly higher in cases of GBL <15% in the axial (OR 3.27, 95% CI 0.92-12.20, p=0.042) and sagittal (OR 3.39, 95% CI 0.95-12.76, p=0.038) planes. In contrast, resorption amount at the inferior screw was not associated with GBL >15% in the axial (p=1) or sagittal (p=0.717) planes. Inferior screw resorption in the axial plane was associated with subsequent revision stabilization procedures (p=0.006).
Conclusion
For Latarjets performed as the index bone block procedure, graft resorption at the superior screw was associated with less glenoid bone loss and smaller coracoid grafts, while inferior resorption was associated with clinical failure.