Rim reconstruction with autogenous iliac crest for anterior glenoid deficiency: forty-three instability cases followed for 5-19 years

Steffen, Viviane; Hertel, R.

doi:10.1016/j.jse.2012.05.038

Cited by 70 publications

(55 citation statements)

References 19 publications

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“…10,11,16,34,37,58 has generated interest in surgical alternatives. Free bone grafting of the anterior glenoid has been used to restore the glenoid articular arc with both allogeneic 39,47,52 and autologous 33,44,46,50 bone grafts. In the treatment of posterior instability, several authors advocate augmentation of the posterior glenoid with a free bone graft, even in the absence of glenoid erosion or dysplasia.…”

Section: Discussionmentioning

confidence: 99%

“…21 In this study we aimed to align the bone graft with the glenoid cartilage, creating a smooth continuation of the articular curvature. Although current surgical technique sometimes advises positioning the graft flush with the level of the subchondral bone 44 in anticipation of fibrocartilage forming over the graft, others have suggested that positioning the graft flush with the cartilage is appropriate as well. 50 …”

Section: Discussionmentioning

confidence: 99%

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Iliac bone grafting of the intact glenoid improves shoulder stability with optimal graft positioning

Willemot

Eby

Thoreson

et al. 2015

Journal of Shoulder and Elbow Surgery

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Background Bone grafting procedures are increasingly popular for the treatment of anterior shoulder instability. In cases with high risk of recurrence, open coracoid transplantation is preferred but can be technically demanding. Free bone graft glenoid augmentation may be an alternative strategy for high-risk patients without significant glenoid bone loss. This biomechanical cadaver study aims to assess the stabilizing effect of free iliac crest bone grafting of the intact glenoid and the importance of sagittal graft position. Methods Eight fresh frozen cadaver shoulders were tested. The bone graft was fixed on the glenoid neck at three sagittal positions (50%, 75% and 100% below the glenoid equator). Displacement and reaction force were monitored with a custom device while translating the humeral head over the glenoid surface in both anterior and antero-inferior direction. Results Peak force (PF) increased significantly from the standard labral repair to the grafted conditions in both anterior (14.7 (±5.5 N) vs. 27.3 (±6.9 N)) and antero-inferior translation (22.0 (±5.3 N) vs. 29.3 (±6.9 N)). PF was significantly higher for the grafts at the 50% and 75% positions, compared to the grafts 100% below the equator with anterior translation. Antero-inferior translation resulted in significantly higher values for the 100% and 75% positions compared to the 50% position. Conclusions This biomechanical study confirms improved anterior glenohumeral stability after iliac crest bone graft augmentation of the anterior glenoid. The results also demonstrate the importance of bone graft position in the sagittal plane, with the ideal position determined by the direction of dislocation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Iliac bone grafting of the intact glenoid improves shoulder stability with optimal graft positioning

Willemot

Eby

Thoreson

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…In the more recent series, with well-fixed transplants, the recurrence rate is very low [13][14][15]17] Arthritis is seen more often, although mostly mild; reports are not always clear on the prevalence of preoperative arthritis and further deterioration. Development of arthritis is possibly prevented when, after fixing the graft the capsule is reattached on the rim of the native glenoid, thus, placing the bone block extra-articularly [15]. Re-attachment of the capsule is recommended, to prevent micro-instability [15].…”

Section: Complicationsmentioning

confidence: 97%

“…Development of arthritis is possibly prevented when, after fixing the graft the capsule is reattached on the rim of the native glenoid, thus, placing the bone block extra-articularly [15]. Re-attachment of the capsule is recommended, to prevent micro-instability [15].…”

Section: Complicationsmentioning

confidence: 99%

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Reconstruction of glenoid bone defects in shoulder instability with autologous bone

Willems¹

2014

Curr Rev Musculoskelet Med

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Bone defects, both at glenoid and at the humeral side are a frequent sequel of anterior shoulder instability. Although the transfer of the coracoid process (Latarjet, Bristow procedures) has gained popularity in treating the glenoid defect, equal results can be achieved with the use of a bone graft, for which mainly a graft of the iliac crest is used. Recently, arthroscopic procedures have been developed, leaving the subscapularis muscle largely intact.

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Bone Deficiencies in Shoulder Instability

Nebelung¹,

Reichwein²,

Nebelung³

2015

Sports Injuries

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Rim reconstruction with autogenous iliac crest for anterior glenoid deficiency: forty-three instability cases followed for 5-19 years

Cited by 70 publications

References 19 publications

Iliac bone grafting of the intact glenoid improves shoulder stability with optimal graft positioning

Iliac bone grafting of the intact glenoid improves shoulder stability with optimal graft positioning

Reconstruction of glenoid bone defects in shoulder instability with autologous bone

Bone Deficiencies in Shoulder Instability

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