Utility of Allograft Talus as a Source for Grafting of Concurrent Humeral and Glenoid Defects Associated With Anterior Glenohumeral Instability: An Anthropometric Analysis

Talar Allograft Preparation for Treatment of Reverse Hill-Sachs Defect in Recurrent Posterior Shoulder Instability

“…8,14,15 To date, there exist a wide variety of allograft options, including fresh or fresh-frozen femoral head, humeral head, allograft plug or the talus allograft. 6,8,11,12,14,15 In their retrospective case series, Zhu et al demonstrated a high union rate and significantly improved subjective and functional outcomes at a mid-term follow-up period (mean 27.8 months) following reconstruction of large HSLs using a freshfrozen humeral head allograft. 14 However, the authors also reported a high graft resorption rate (43.1%).…”

“…First, the anthropometric measurements of the talus are almost identical to the radius of curvature (ROC) of the humeral head, optimizing restoration of the humeral head sphericity and its arc of rotation with respect to the glenoid surface. 10,11 Additionally, the dense, weight-bearing cartilaginous surface of the talus creates a more profound articular contact with the glenoid and allows for The anatomic landmarks for the final cut (depth) are the junction of the articular surface of the talar dome and the talar neck for the anterior anatomic landmark (seen above) and the posterior margin of the talar articular cartilage for the posterior anatomical landmark. more stability.…”

“…9 Recent literature has indicated that the talus serves as a robust grafting alternative site for the humeral head, as the talar dome shows high congruency and offers a maximum size of 30 Â 10 mm for a single graft. 6,[10][11][12] Moreover, anthropometric properties of talus are similar to the native humeral head and the radius of curvature (ROC) of the glenoid. 11 Although techniques using talus allograft for humeral head reconstruction have been described in the previous literature, it is essential to provide an outlined preparatory allograft procedure that optimizes bone union.…”

“…6,[10][11][12] Moreover, anthropometric properties of talus are similar to the native humeral head and the radius of curvature (ROC) of the glenoid. 11 Although techniques using talus allograft for humeral head reconstruction have been described in the previous literature, it is essential to provide an outlined preparatory allograft procedure that optimizes bone union. The purpose of this Technical Note is, therefore, to describe our technique for talus allograft preparation for the treatment of a large rHSL that highlights precise cutting anatomy, sizing options, and use of orthobiologics to ensure excellent talus union to the native humeral head surface.…”

Anterior Shoulder Instability Part II—Latarjet, Remplissage, and Glenoid Bone-Grafting—An International Consensus Statement

“…9 While proponents of using autograft sources, such as iliac crest cite theoretically improved healing rates and a lower cost over allograft, distal tibial allograft has, thus, far proven to reliably match the congruity of the glenoid arc and has demonstrated excellent union rates. [10][11][12][13][14] Humeral-sided bone loss resulting in an "off-track" and/or engaging Hill-Sachs lesion is commonly treated either indirectly with one of the above procedures, or directly by means of a remplissage. 15 The remplissage procedure, first described by Dr. Eugene Wolf in 2008, acts to fill the lesion and render it extra-articular through tenodesis of the infraspinatus and posterior capsule into the defect.…”