Anthropometric and Radiologic Measurements of Coracoid Dimensions and Clinical Implications in an Indian Population

Abstract

Background:Recurrent shoulder dislocation and anterior instability are most commonly attributed to pathology of the capsulolabral complex with the presence of bony loss at the humeral and glenoid surfaces. Unassessed bone loss has been a cause of failure of primary soft tissue procedures or recurrence of symptoms, despite adequate address of soft tissue pathology.Purpose:To study the anthropometric and radiologic dimensions of the coracoid in relation to glenoid bone loss, its adequacy in filling glenoid defects in an Indian population, and whether the choice of surgical technique (congruent arc vs classical) and graft positioning alters the surgical results. This study also intended to establish whether computed tomography measurements correlate with actual anthropometric measurements.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 64 participants with 108 healthy shoulders were included in this study. Additionally, 100 skeletally mature bone specimens of the scapula were measured to assess glenoid diameter as well as coracoid width and length in 2 perpendicular planes with a humeral subtraction 3-dimensional en face glenoid view.Results:Specimen and participant measurements proved that the congruent arc technique was able to fill up to 50% more glenoid bone loss than the classical technique in an Indian population (mean ± SD, 13.45 ± 6.97 vs 7.96 ± 4.89 mm, respectively), with computed tomography being the best and most accurate modality to study it. The mean difference in the bone block length restoration of the glenoid bony arc was 5.41 ± 2.08 mm. Radii of curvature were congruent in populations of the Indian subcontinent.Conclusion:The congruent arc technique can be performed in an Indian population but with caution and careful presurgical assessment of bone loss. However, adequate coracoid dimension to accommodate the implant for fixation without failure must be ensured, as anthropometry suggests the existence of a subset of the population in whom the graft may have compromised width for accommodating standard implants for fixation.

Best implant choice for coracoid graft fixation during the Latarjet procedure depends on patients’ morphometric considerations

“…Therefore, in 46% of the cases there was less than the ideal length of 25 mm, according to the original technique [11,15] [19,20]. From the aforementioned studies and the international literature, the coracoid length seems to be positively affected by male gender, age, overall height and Caucasian genetics [12,13,17,20,21]. In our study population, the height of the cadavers was not available, however we observed a positive correlation with the glenoid height.…”

Comparing the Anatomical Landmarks Versus the Coracoid-Based Landmarks Techniques for Coracoclavicular Stabilization After High-Grade Acromioclavicular Injury: A Biomechanical Study

“…Creating a tunnel is suitable for a large coracoid base, such as is generally found in Western populations, 14 , 19 but in East/Southeast Asian populations, this creates a risk of iatrogenic fracture due to the small size of the coracoid base. 6 , 11 For this reason, in East/Southeast Asian populations, most surgeons prefer to loop a suture under the coracoid base rather than creating a coracoid tunnel. The second feature is the clavicle, in which the surgeon can create 1 or 2 clavicular tunnels, with some studies reporting that the double clavicular tunnel method had better clinical and/or radiographic outcomes than the single tunnel method.…”

Effect of Preoperative MRI Coracoid Dimensions on Postoperative Outcomes of Latarjet Treatment for Anterior Shoulder Instability

“…These cutoffs were selected as the whole numbers nearest the means of coracoid length and width in this patient cohort, with several CT studies finding a mean coracoid length between 21 and 24 mm. 14 , 16 , 19 Demographic and postoperative outcomes were compared between shorter and longer coracoids, narrower and wider coracoids, and male and female coracoid dimensions. Independent-samples t tests were utilized to calculate P values for parametric data, and Mann-Whitney tests were used to calculate P values for nonparametric data.…”