Fijación artroscópica sin metal del bloque óseo en la inestabilidad anterior del hombro. Resultados funcionales y radiológicos a corto plazo

Hachem, Abdul-ilah; Carmen-Rodriguez, M. Del; Rondanelli, R.; Ríus, Xavier; Molina-Creixell, Andrés; Pastor, Pablo Cañete San; Hernández-Gañan, Javier; Cabo, Francisco Javier

doi:10.1016/j.recot.2021.05.007

Cited by 4 publications

(1 citation statement)

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“…Two years later, when analyzing their series of 72 patients undergoing an arthroscopic bone-block procedure using distal tibia allograft, Wong et al found a 100% union rate and graft resorption <50% in 86% of patients, much lower than the resorption rate found in our study. On the other hand, when using the autograft bone-block procedure, just 50% of patients experienced osteolysis in our study, a similar rate to the one reported by Hachem et al, 22 who found resorption in 32.5% of patients, with a higher resorption rate at the peripherical area when compared with the areas with glenoid contact.…”

Section: Discussionsupporting

confidence: 91%

Graft Position, Healing, and Resorption in Anterior Glenohumeral Instability: A Comparison of 4 Glenoid Augmentation Techniques

Delgado,

Calvo,

Díaz Heredia

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: The success of glenoid augmentation procedures depends on accurate placement and healing of the graft to the glenoid. Different glenoid augmentation techniques have been described, but no comparative studies between them exist. Purpose: To assess the bone graft position, healing, and resorption in a group of patients treated with 1 of 4 procedures: arthroscopic anterior bone-block procedure using either (1) fresh-frozen iliac crest allograft or (2) iliac crest autograft, (3) open Latarjet, or (4) arthroscopic Latarjet. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 40 patients (87.5% men; mean age, 29.5 ± 7.9 years) were included, with 10 patients in each of the procedure groups. The graft position in the axial and sagittal planes was assessed on postoperative computed tomography (CT). Graft healing and resorption were assessed in a second CT scan performed 1 year postoperatively. Qualitative variables were compared between the 4 procedures using the chi-square test, and quantitative variables were compared with the Student t test or Mann-Whitney U test. Results: No differences were found between the procedures in the axial or sagittal position. The healing rate was significantly lower in the allograft bone-block group (20%) compared with the autograft bone-block (80%), open Latarjet (90%), and arthroscopic Latarjet (90%) groups ( P < .001). Graft resorption developed in 17 of 40 (42.5%) cases overall. Osteolysis occurred in 100% of cases in the allograft bone-block group compared with 50% in the autograft group, 20% in the open Latarjet group, and 0% in the arthroscopic Latarjet group ( P < .001). The glenoid surface area on 1-year CT scan was significantly lower in the allograft bone-block group compared with the autograft bone-block, open Latarjet, and arthroscopic Latarjet groups ( P < .001). Conclusion: Arthroscopic bone-block, open Latarjet, and arthroscopic Latarjet procedures provided accurate bone graft positioning. However, very high rates of osteolysis and nonunion were observed in the iliac crest fresh-frozen allograft bone-block procedure when compared with the other procedures.

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Section: Discussionsupporting

confidence: 91%