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Case Reports
. 2024 May 6;4(3):540-546.
doi: 10.1016/j.xrrt.2024.04.008. eCollection 2024 Aug.

Osteochondral allograft transplantation for articular humeral head defect from ballistic trauma

Melissa Soderquist  1 , Leslie Barnes  1
Affiliations
Case Reports

Osteochondral allograft transplantation for articular humeral head defect from ballistic trauma

Melissa Soderquist et al. JSES Rev Rep Tech. .
No abstract available

Keywords: Full-thickness cartilage loss; Gunshot wound; Humeral head; OCA; Osteochondral allograft transplant; Shoulder trauma.

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Figures

Figure 1
Figure 1
This image demonstrates the initial wound that the patient presented with to the emergency department, which is located at the left inferior aspect of the posterolateral axilla with the bullet trajectory directly into the axilla.
Figure 2
Figure 2
Initial injury radiograph, ballistic embedded in the humeral head.
Figure 3
Figure 3
CT scan of retained missile in the humeral head. CT, computed tomography.
Figure 4
Figure 4
Foreign body protruding from the subchondral bone at time of surgery.
Figure 5
Figure 5
Extricated bullet in its entirety.
Figure 6
Figure 6
Humeral head osteochondral defect after bullet extrication.
Figure 7
Figure 7
A 9-mm reamer used to clean debris from the osteochondral defect.
Figure 8
Figure 8
Fresh osteochondral allograft, 10 mm × 14 mm in size (Arthrex Inc., Naples, FL, USA).
Figure 9
Figure 9
Osteochondral allograft press-fit into the osteochondral defect.
Figure 10
Figure 10
The subscapularis was repaired to bone using suture anchors and the upper border repair was reinforced with suture.
Figure 11
Figure 11
Stable appearing OCA on radiographic imaging at 2 weeks postoperative visit. OCA, osteochondral allograft transplantation.
Figure 12
Figure 12
Active forward flexion at 20 months postoperative visit.
Figure 13
Figure 13
External rotation at 20 months postoperative visit.
Figure 14
Figure 14
Stable, healed OCA on radiographic imaging at 20 months postoperative visit. OCA, osteochondral allograft transplantation.
See this image and copyright information in PMC

References

    1. Arthrex Inc. precut fresh osteochondral allograft cores. Product Manual. 2018
    1. Bentley G., Biant L.C., Carrington R.W., Akmal M., Goldberg A., Williams A., et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003;85:223–230. doi: 10.1302/0301-620x.85b2.13543. - DOI - PubMed
    1. Boehm E., Minkus M., Scheibel M. Autologous chondrocyte implantation for treatment of focal articular cartilage defects of the humeral head. J Shoulder Elbow Surg. 2020;29:2–11. doi: 10.1016/j.jse.2019.07.030. - DOI - PubMed
    1. Bowyer G.W., Rossiter N.D. Management of gunshot wounds of the limbs. J Bone Joint Surg Br. 1997;79:1031–1036. - PubMed
    1. Cavendish P.A., Everhart J.S., Peters N.J., Sommerfeldt M.F., Flanigan D.C. Osteochondral allograft transplantation for knee cartilage and osteochondral defects: a review of indications, technique, rehabilitation, and outcomes. JBJS Rev. 2019;7 doi: 10.2106/JBJS.RVW.18.00123. - DOI - PubMed

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