Arthroscopic reconstruction of chronic anteroinferior glenoid defect using an autologous tricortical iliac crest bone grafting technique

Scheibel, Markus; Kraus, Natascha; Diederichs, Gerd; Haas, Norbert

doi:10.1007/s00402-007-0509-2

Cited by 97 publications

(78 citation statements)

References 17 publications

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“…Although there are several studies on the treatment for glenoid bone loss [23,25,[33][34][35][36][37][38], bone defects of the humeral head have not been thoroughly evaluated. There is little consensus regarding surgical indications or standard treatments to reconstruct defects of the humeral head [22].…”

Section: Discussionmentioning

confidence: 99%

Anterior shoulder instability with engaging Hill–Sachs defects: a comparison of arthroscopic Bankart repair with and without posterior capsulodesis

Cho

Yoo

Juh

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionmentioning

confidence: 99%

Anterior shoulder instability with engaging Hill–Sachs defects: a comparison of arthroscopic Bankart repair with and without posterior capsulodesis

Cho

Yoo

Juh

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…6 Other authors have described and reported bone block procedures for anteroinferior glenohumeral instability, but our technique is the first performed entirely arthroscopically without the use of screws. [7][8][9][10][11] The well-established advantages of using arthroscopy for shoulder stabilization include smaller incisions with less soft-tissue dissection and improved ability to completely inspect the glenohumeral joint and access all areas of the joint for repair, as well as preservation of external rotation. In case of mechanical inconsistency or absence of the soft tissues, it is possible to switch to an arthroscopically assisted Latarjet procedure that we have recently described.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Bone Graft Procedure for Anterior Inferior Glenohumeral Instability

Taverna

D’Ambrosi

Perfetti

et al. 2014

Arthroscopy Techniques

102

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There are many described surgical techniques for the treatment of recurrent anterior shoulder instability. Numerous authors have performed anterior bone block procedures with good results for the treatment of anterior shoulder instability with glenoid bone loss. The benefits of using arthroscopic procedures for surgical stabilization of the shoulder include smaller incisions with less soft-tissue dissection, better visualization of the joint, better repair accessibility, and the best possible outcome for external rotation. We describe an arthroscopic anteroinferior shoulder stabilization technique with an iliac crest tricortical bone graft and capsulolabral reconstruction. It is an all-arthroscopic technique with the advantage of not using fixation devices, such as screws, but instead using special buttons to fix the bone graft. The steps of the operation are as follows: precise placement of a specific posterior glenoid guide that allows the accurate positioning of the bone graft on the anterior glenoid neck; fixation of the graft flush with the anterior glenoid rim using specific buttons under arthroscopic control; and finally, subsequent capsular, labral, and ligament reconstruction on the glenoid rim using suture anchors and leaving the graft as an extra-articular structure.

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“…1,2,10 There are only a few published all-arthroscopic iliac crest graft augmentation techniques, including those of Taverna et al 11 using metal screws and, more recently, EndoButton devices (Smith & Nephew); Scheibel et al 12 with the use of bioabsorbable screws; and Anderl et al 13 with implant-free, Jebone graft reconstruction. 14 We consider our proposed technique to have several advantages (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Iliac Crest Bone Block for Reconstruction of the Glenoid: A Fixation Technique Using an Adjustable-Length Loop Cortical Suspensory Fixation Device

Kalogrianitis

Tsouparopoulos

2016

Arthroscopy Techniques

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Recurrent anterior shoulder instability with significant bone loss represents a surgical challenge. Anterior bone block procedures including variations of the Latarjet coracoid transfer have been used in this setting. Bone graft resorption with prominence of the metalwork is a serious concern, whereas the relative contribution of the dynamic sling effect of a Latarjet procedure is still controversial. We describe an arthroscopic technique for anatomic reconstruction of anterior glenoid bone defects using autologous iliac crest graft. This technique allows accurate placement of the bone block; fixation with 2 knotless TightRope devices (Arthrex, Naples, FL), avoiding the use of screws; and a final labral repair. R ecurrent anterior shoulder instability is associated with bone loss in 90% of cases. With significant bone loss, primary arthroscopic Bankart repair carries a high risk of failure in more than 70% of cases. Although not clearly defined yet, biomechanical studies suggest that critical glenoid bone loss is around 20%. Most of the defects, though, are bipolar lesions and can be managed with glenoid-based surgery. On the glenoid side, the workhorse has been the Latarjet procedure and its variations. Other options include the use of tricortical iliac crest graft or distal tibial allograft. The arthroscopic Latarjet procedure has been gaining increasing popularity recently, whereas only a few arthroscopic techniques have been described for iliac crest bone graft. 1,2We describe an arthroscopic technique for reconstruction of the anterior glenoid with iliac crest graft. We use a specific posterior glenoid guide (Arthrex, Naples, FL) for accurate graft positioning, and the bone block is introduced through the rotator interval and secured in place with 2 knotless TightRope-RT devices (Arthrex), which are adjustable-length loop devices tensioned between cortical buttons (Arthrex) with a suture tensioner (Arthrex). This knotless fixation method eliminates the use of screws and their potential problems (Video 1, Table 1). Indications and Preoperative PlanningWe consider arthroscopic reconstruction of the glenoid with iliac crest bone graft in cases with glenoid bone loss greater than 20%, in cases with glenoid bone loss between 10% and 20% in younger patients (aged <20 years) involved in competitive or contact sports, and in bipolar lesions involving the glenoid and humeral head. Patients usually undergo magnetic resonance arthrography and routinely undergo threedimensional computed tomography of the shoulder with digital subtraction of the humeral head to provide an en face sagittal view of the glenoid. The percentage of glenoid bone loss can be calculated by modeling the inferior aspect of the intact glenoid as a true circle. Iliac Crest Graft HarvestingThe tricortical iliac crest graft is harvested from the ipsilateral side with the technique described by Warner et al. 2 The dimensions of the block are usually 2 cm in length Â 1 cm in height Â 1 cm in width, although the size can be customized dependin...

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Arthroscopic reconstruction of chronic anteroinferior glenoid defect using an autologous tricortical iliac crest bone grafting technique

Cited by 97 publications

References 17 publications

Anterior shoulder instability with engaging Hill–Sachs defects: a comparison of arthroscopic Bankart repair with and without posterior capsulodesis

Anterior shoulder instability with engaging Hill–Sachs defects: a comparison of arthroscopic Bankart repair with and without posterior capsulodesis

Arthroscopic Bone Graft Procedure for Anterior Inferior Glenohumeral Instability

Arthroscopic Iliac Crest Bone Block for Reconstruction of the Glenoid: A Fixation Technique Using an Adjustable-Length Loop Cortical Suspensory Fixation Device

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