Christian Deml1,2, Peter Kaiser1, Wouter F van Leeuwen2, Magdalena Zitterl1, Simon A Euler3. 1. Department of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria. 2. Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Cambridge, Massachusetts, USA. 3. Department of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria simon.euler@tirol-kliniken.at.
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.
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.
Authors: Ron Gilat; Stephanie E Wong; Ophelie Lavoie-Gagne; Eric D Haunschild; Derrick M Knapik; Michael C Fu; Jorge Chahla; Brian Forsythe; Brian J Cole Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-08-04 Impact factor: 4.342