Novel Arthroscopic Technique for Anatomic Glenoid Reconstruction: Short Term Results and Safety Profile

Eyal Amar 1 Catherine Coady 1 Ben Smith 2 Ivan Wong 1
1Department of Surgery, Division of Orthopedics, Dalhousie University and the Queen Elizabeth II Health Sciences Centre, Halifax, Canada
2Division of Orthopedics, Joseph Brant Memorial Hospital, Burlington, Canada

Background: The results of arthroscopic anterior labral repair have been shown to have high failure rate in patients with significant glenoid bone loss. Several reconstruction procedures using bone graft have been described to overcome the bone loss, including autogenous coracoid transfer, iliac crest autograft and tibial allografts.

Purpose: to retrospectively analyze prospectively collected data to evaluate the clinical and radiological outcome of patient who underwent anatomic glenoid reconstruction using distal tibia allograft for the treatment of shoulder instability at a minimum of 6 months follow-up.

Materials and methods: 44 patients underwent arthroscopic stabilization of the shoulder by means of capsule-labral reattachment and bony augmentation of glenoid bone loss with distal tibial allograft for recurrent instability of the shoulder. Preoperative and postoperative evaluation included general assessment by the Western Ontario Shoulder Instability index (WOSI), preoperative and postoperative radiographs and CT scans.

Results: Forty-four patients met inclusion criteria and were initially evaluated. The mean age of the study population was 30.65 years. Mean clinical follow-up period of 17.44 months.

One case of fracture occurred 6 weeks after surgery with no other symptomatic subluxations or dislocations. The mean of preoperative and postoperative WOSI score was 38.89 and 72.09 (p<0.0001).

Mean radiographic follow-up was 7.4 months. There were four cases of graft position in middle third and one case of superior third position. Two cases of non-union that required revision. Three cases of allograft resorption and six cases of partial resorption were recorded and required no intervention.

No adverse effects were recorded in the immediate post-operative period. No neuro-vascular (NV) impairments were recorded throughout the follow up period.

Conclusions: Arthroscopic stabilization of the shoulder with distal tibia allograft augmentation demonstrates promising result at a minimum of 6 months follow-up.