2025 ISAKOS Biennial Congress ePoster
Patient Specific Instrumentation For Open Latarjet Procedure. Technique, Accuracy And Short Term Outcome.
Emmie van den Elzen, BSc, Venlo NETHERLANDS
Okke Lambers Heerspink, MD, PhD, Venlo NETHERLANDS
Esther Janssen, PhD, Venlo NETHERLANDS
Maichel Gommans, Mr, Venlo, Limburg NETHERLANDS
Berend Geelen, Mr, Venlo NETHERLANDS
Bruno Borralho Gobbato, Jaragua Do Sul, SC BRAZIL
Freek Hollman, MD, PhD, Venlo NETHERLANDS
VieCuri Medical Center, Venlo, NETHERLANDS
FDA Status Not Applicable
Summary
The open PSI Latarjet procedure is a safe and reliable procedure with good radiological results in terms of bone graft alignment and graft union at 6-weeks postoperatively.
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Abstract
Background
The Latarjet procedure is a well-known technique for patients with anterior shoulder instability. However, inadequate positioning of the coracoid bone graft may lead to persistent instability, early arthritis and screw malpositioning. In open Latarjet the complication rate is described up to 15%. Adequate bone-block positioning based on patients scapular morphology could contribute to less complications on the short and long term. Therefore, it is hypothesized that the use of patient-specific 3D-printed guides in the open Latarjet procedure may enhance the accuracy of coracoid graft positioning.
Aim
To optimize the Patient-Specific Instrumentation (PSI) Latarjet procedure by detailing the technique and assessing the accuracy of graft and screw positioning through comparing the digital performance of the procedure with the performed open PSI Latarjet procedure.
Methods
From January 2024 to May 2024, five patients with anterior shoulder instability underwent the open PSI Latarjet procedure. Ethical approval is obtained. Using CAD software, the surgical procedure was digitally planned and PSI drill guides designed and printed. A coracoid PSI drill guide and matching glenoid PSI drill guide were used in a standard double screw technique open Latarjet procedure. Patients were immobilized for three weeks with radiological evaluations at six weeks to assess graft-host alignment and consolidation and clinical outcomes measured at three months postoperatively.
Results
In total, five consecutive patients were included. The mediolateral position was on average 1.8 mm displaced laterally (range 0.6 – 5.6), the craniocaudal position was on average 3.2 mm displaced caudal (range 5.16 mm caudal - 5.58 mm cranial), from what was digitally planned. All bone grafts achieved complete consolidation. No residual instability was experienced after 3 months of follow-up.
Conclusions
The open PSI Latarjet procedure is a safe and reliable procedure with good radiological results in terms of bone graft alignment and graft union at 6-weeks postoperatively. Clinical outcomes demonstrated no recurrence or complications at 3 months postoperatively. We believe that 3D printing shifts the traditional paradigm for surgeons, moving from the consistent use of standard, tested instruments to exploring new possibilities and innovative tools.