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. 2015 Jan;7(1):36-43.
doi: 10.1177/1758573214557147. Epub 2014 Oct 30.

Outcomes for intra-substance free coracoid graft in patients with antero-inferior instability and glenoid bone loss in a population of high-risk athletes at a minimum follow-up of 2 years

Afshin Arianjam  1 , Simon N Bell  2 , Jennifer Coghlan  2 , Jason Old  3 , Roger Sloan  2
Affiliations

Outcomes for intra-substance free coracoid graft in patients with antero-inferior instability and glenoid bone loss in a population of high-risk athletes at a minimum follow-up of 2 years

Afshin Arianjam et al. Shoulder Elbow. 2015 Jan.

Abstract

Background: The aim of this retrospective case series study was to assess the outcomes of patients with recurrent anterior shoulder instability with antero-inferior glenoid bone loss treated with a specific open stabilization technique using intra-substance coracoid bone-grafting and Bankart repair.

Methods: Over a 4-year period, 34 shoulders in all male patients of mean age 21 years were stabilized with this technique. Pre- and postoperative function, motion and stability were assessed as part of Rowe stability scoring, and American Shoulder and Elbow Surgeons (ASES) and Oxford Instability were recorded, with at least 2 years of follow-up in all patients. Union of the graft was determined by post-operative computed tomography (CT) of the affected shoulder.

Results: For all cases, two redislocations (5.9%) and two subluxations occurred when continuing high-risk sport after 2 years. Post-operative scores [median, mean (SD): Rowe 77.5, 77.2 (19.5); ASES 94.2, 92 (7.7); Oxford 43, 41.2 (6)]. CT scans on 28 shoulders at a mean of 4.5 months after surgery showed non-union in three cases (10%).

Conclusions: These results demonstrate a high rate of success in cases of glenoid bone loss in the young contact athlete with recurrent instability treated with open stabilization and bone grafting.

Keywords: bone graft; glenoid deficiency; glenoid reconstruction; shoulder instability.

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Figures

Figure 1.
Figure 1.
Attachment of the suture anchor to the glenoid defect.
Figure 2.
Figure 2.
Extra-articular attachment of the free bone graft over the Bankart repair.
Figure 3.
Figure 3.
Coronal computed tomography images following bony union of the free bone graft.
Figure 4.
Figure 4.
Axial computed tomography scan images following bony union of the free bone graft.
Figure 5.
Figure 5.
Three-dimensional computed tomography reconstruction of the incoporated graft.
Figure 6.
Figure 6.
Three-dimensional computed tomography reconstruction demonstrating a fractured graft after a traumatic dislocation 3 years after the index surgery.
See this image and copyright information in PMC

References

    1. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 2000; 16: 677–94. - PubMed
    1. Wolf EM, Arianjam A. Hill–Sachs remplissage, an arthroscopic solution for the engaging Hill–Sachs lesion: 2- to 10-year follow-up and incidence of recurrence. J Shoulder Elb Surg Am Shoulder Elb Surg Al 2014; 23: 814–30. - PubMed
    1. Bigliani LU, Newton PM, Steinmann SP, Connor PM, Mcllveen SJ. Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med 1998; 26: 41–5. - PubMed
    1. Boileau P, Villalba M, Héry J-Y, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 2006; 88: 1755–63. - PubMed
    1. Edwards TB, Boulahia A, Walch G. Radiographic analysis of bone defects in chronic anterior shoulder instability. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 2003; 19: 732–9. - PubMed

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