Anatomic Osteochondral Glenoid Reconstruction for Recurrent Glenohumeral Instability With Glenoid Deficiency Using a Distal Tibia Allograft

Provencher, Matthew T.; Ghodadra, Neil; LeClere, Lance E.; Solomon, Daniel J.; Romeo, Anthony A.

doi:10.1016/j.arthro.2008.10.017

Cited by 259 publications

(220 citation statements)

References 39 publications

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“…Several studies have commented on the use of allografts for glenoid reconstructions. These include distal tibia [71] and femoral head allografts [72] . It has been proposed that the use of allografts may have several advantages over autografts including a more accurate restoration of the anatomical contour of the glenoid as well as the addition of a cartilaginous interface for articulation with the humeral head.…”

Section: Glenoid Bone Lossmentioning

confidence: 99%

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Ramhamadany

Modi

2016

WJO

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The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures.

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Section: Glenoid Bone Lossmentioning

confidence: 99%

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Ramhamadany

Modi

2016

WJO

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“…Potential drawbacks include antigenicity, theoretical issues with osseous union, and donor bone quality. 2 These drawbacks are mitigated by sterile processing in accordance with the American Association of Tissue Banks, thorough footprint preparation, rigid fixation, and age-appropriate graft harvest.…”

Section: Discussionmentioning

confidence: 99%

“…It avoids the morbidity associated with autologous iliac crest bone grafting and provides an additional articular cartilage bearing surface. 1,2 The arthroscopic distal tibial allograft procedure described is a reproducible technique that can lead to successful outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic Distal Tibial Allograft Augmentation for Posterior Shoulder Instability With Glenoid Bone Loss

Gupta

Chalmers

Klosterman

et al. 2013

Arthroscopy Techniques

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Glenoid bone loss is commonly associated with recurrent shoulder instability. Failure to recognize and appropriately address it can lead to poor outcomes. Numerous studies have found anterior-inferior glenoid bone loss in the setting of recurrent anterior instability. Though much less common, posterior shoulder instability can be seen in the setting of acute trauma, epilepsy, electrocution, and alcoholism. Heightened awareness has led to recognition in collision athletes as well. Posterior glenoid bone loss must be addressed in a similar fashion to anterior glenoid bone loss to prevent recurrent instability. Open bone augmentation procedures have been described with successful results. In this technical note, we describe an arthroscopic technique using fresh distal tibial allograft for posterior glenoid augmentation. In addition, a current review regarding the diagnosis and management of recurrent posterior shoulder instability is provided.

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“…Among the options was to reconstruct the glenoid with autologous bone transfer from the iliac crest or allogenous bone graft. 5,6 A bone graft would fill the defect in front of the glenoid but it would have not given the functional support as the Latarjet procedure with its conjoined tendon sling. 7 Fig.…”

Section: Discussionmentioning

confidence: 99%

A combination of Latarjet and Remplissage for treatment of severe glenohumeral instability and bone loss. A case report

Ranne

Sarimo

Heinonen

et al. 2013

Journal of Orthopaedics

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RemplissageShoulder instability a b s t r a c t Recurrent glenohumeral instability is challenging to treat when large bony defects are present in the anterior glenoid and there is a large HilleSachs lesion. We present a case with extensive glenoid and humeral bone loss treated with open Latarjet procedure combined with posterior arthroscopic Remplissage. 3.5 years after surgery, there have been no dislocations or any subjective signs of instability. After half a year, the patient was able to return to work as an airline pilot. Constant score has improved from 33 to 74 and the Oxford instability score from 8 to 46. We find that in young patients with difficult instability combining the Latarjet and Remplissage is a good and replicable method.Copyright ª 2013, Professor P K Surendran Memorial Education Foundation. Publishing Services by Reed Elsevier India Pvt. Ltd. All rights reserved. IntroductionRecurrent glenohumeral instability is challenging to treat when large bony defects are present in the anterior glenoid and there is a large HilleSachs lesion. We present a case with extensive glenoid and humeral bone loss treated with open Latarjet procedure combined with posterior arthroscopic Remplissage. At the time of operation the patient was 32 years old, a healthy physically fit male who sustained his first glenohumeral dislocation of the left shoulder 12 years before in a skiing accident. The initial treatment was conservative. The shoulder became increasingly unstable and frequent dislocations occurred with only minor external force. The patient estimated that more than one hundred dislocations had occurred in the left shoulder.The patient worked as an airline pilot. The grave instability made it virtually impossible to reach the upper controls of an airliner. The dislocations were usually not painful and the patient was able to relocate the shoulder by himself. The preoperative findingsIn clinical examination the shoulder was unstable in the anterior direction. The apprehension test resulted in subluxation which the patient instantly relocated by himself. The Constant score was 33 and the Oxford instability score 8. MRI and CT scans showed a large anterior bony glenoid lesion with a large engaging HilleSachs lesion. Early signs of arthrosis were seen in the inferior part of the glenoid. The form of the glenoid was the kind which Burkhart et al have described as a banana glenoid (Fig. 1). 1,2 The Latarjet procedure was chosen to control the anterior instability because of the sling effect of the conjoined tendon. * Corresponding author. Hospital NEO, Joukahaisenkatu 6, 20520 Turku, Finland. Tel.: þ358 400 597978.E-mail address: juha.ranne@hospitalneo.com (J.O. Ranne).Available online at www.sciencedirect.com journal homepage: w ww.el sevier.com/locate /jor j o u r n a l o f o r t h o p a e d i c s 1 0 ( 2 0 1 3 ) 4 6 e4 8

show abstract

Anatomic Osteochondral Glenoid Reconstruction for Recurrent Glenohumeral Instability With Glenoid Deficiency Using a Distal Tibia Allograft

Cited by 259 publications

References 39 publications

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Arthroscopic Distal Tibial Allograft Augmentation for Posterior Shoulder Instability With Glenoid Bone Loss

A combination of Latarjet and Remplissage for treatment of severe glenohumeral instability and bone loss. A case report

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