The J-Shaped Bone Graft for Anatomic Glenoid Reconstruction: A 10-Year Clinical Follow-up and Computed Tomography-Osteoabsorptiometry Study

Abstract

Background: The J-shaped bone graft procedure is one of the recommended methods to reconstruct significant glenoid rim defects.

Purpose: To evaluate long-term (minimum 10-year) clinical outcomes and show further details of the remodeling effects on the articular cavity of the glenoid after J-shaped bone grafting.

Study design: Case series; Level of evidence, 4.

Methods: A total of 14 patients treated with a J-shaped bone graft procedure were observed clinically. Additionally, bilateral preoperative and postoperative follow-up computed tomography (CT) scans were used for CT-osteoabsorptiometry (OAM) to evaluate the bony remodeling processes.

Results: The follow-up rate was 93% at a mean follow-up time of 10.7 years (range, 10.08-11.75 years). Patients exhibited a mean Constant score of 92.5 (range, 80-100) on the clinical evaluation. All patients had free range of motion and were pain free without any recurrence of instability. Based on CT-OAM, comparable and almost anatomically reconstructed, bilaterally equal glenoid cavities were found postoperatively. The distribution patterns of glenoid subchondral mineralization were bilaterally equal in 85.7% of the patients.

Conclusion: The surgical treatment of recurrent shoulder instability with a significant bony Bankart lesion using the J-shaped bone graft procedure provided excellent long-term results. This study lends evidence to support the capability of the J-shaped bone graft procedure to restore the normal glenoid shape due to physiological remodeling processes.

Keywords: CT-OAM; bone graft; density distribution; glenoid; instability; shoulder.