Guillaume Villatte1,2, Antoine Martins3, Roger Erivan3,4, Bruno Pereira5, Stéphane Descamps3,4, Stéphane Boisgard3,4. 1. Service d'Orthopédie-Traumatologie, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, BP 69, 63003, Clermont-Ferrand Cedex 01, France. guivillatte@gmail.com. 2. Institut de Chimie de Clermont-Ferrand, Université Clermont Auvergne, SIGMA Clermont, CNRS, UMR 6296, ICCF, 63178, Aubière, France. guivillatte@gmail.com. 3. Service d'Orthopédie-Traumatologie, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, BP 69, 63003, Clermont-Ferrand Cedex 01, France. 4. Institut de Chimie de Clermont-Ferrand, Université Clermont Auvergne, SIGMA Clermont, CNRS, UMR 6296, ICCF, 63178, Aubière, France. 5. DRCI, CHU de Clermont-Ferrand, BP 69, 63003, Clermont-Ferrand Cedex 01, France.
Abstract
INTRODUCTION: Bone-block procedures are well-established in anterior chronic shoulder instability treatment. Autograft with the coracoid process (Bristow-Latarjet procedures) and iliac crest (Eden-Hybbinette) are the most frequent source of bone but the use of allograft is also possible. The objective of this review is to assess clinical and radiographic outcomes after bony allograft reconstruction in anterior glenohumeral instability. MATERIAL AND METHODS: Medline, Cochrane, Embase databases were searched for studies reporting on bone allograft reconstruction in anterior glenohumeral instability with glenoid defect. We conducted a systematic review of studies with all levels of evidence reporting on clinical or radiological outcomes or both. LEVEL OF EVIDENCE: IV. RESULTS: Ten studies met the inclusion criteria for the review; 283 shoulders were included with a mean age of 26 years (17-63) and mean follow-up of 34 months (4-168). Glenoid reconstruction was performed using bone from different source: femoral head (1 study), distal tibia allograft (5 studies), and iliac crest (4 studies). Allografts were fresh in 4 studies, demineralized in 2 studies, and freeze-dried after sterilization in 1 study. All scores performed in the different studies increased between pre-operative and post-operative evaluations (mean + 36.8 points for the ASES). Global rate of recurrence was 3.9% (11 patients) (0-11%), comprising 6 cases of dislocation (2.1%) and 5 subluxations (1.8%). Allograft healing occurred in 93.5% of cases. CONCLUSIONS: This systematic review data suggest that allograft reconstructions in anterior glenohumeral instability could be a viable alternative to similar reconstructions with autografts and provide close clinical/radiological outcomes, at short and mid-term follow-up. Prospective randomized studies are needed to confirm these results.
INTRODUCTION: Bone-block procedures are well-established in anterior chronic shoulder instability treatment. Autograft with the coracoid process (Bristow-Latarjet procedures) and iliac crest (Eden-Hybbinette) are the most frequent source of bone but the use of allograft is also possible. The objective of this review is to assess clinical and radiographic outcomes after bony allograft reconstruction in anterior glenohumeral instability. MATERIAL AND METHODS: Medline, Cochrane, Embase databases were searched for studies reporting on bone allograft reconstruction in anterior glenohumeral instability with glenoid defect. We conducted a systematic review of studies with all levels of evidence reporting on clinical or radiological outcomes or both. LEVEL OF EVIDENCE: IV. RESULTS: Ten studies met the inclusion criteria for the review; 283 shoulders were included with a mean age of 26 years (17-63) and mean follow-up of 34 months (4-168). Glenoid reconstruction was performed using bone from different source: femoral head (1 study), distal tibia allograft (5 studies), and iliac crest (4 studies). Allografts were fresh in 4 studies, demineralized in 2 studies, and freeze-dried after sterilization in 1 study. All scores performed in the different studies increased between pre-operative and post-operative evaluations (mean + 36.8 points for the ASES). Global rate of recurrence was 3.9% (11 patients) (0-11%), comprising 6 cases of dislocation (2.1%) and 5 subluxations (1.8%). Allograft healing occurred in 93.5% of cases. CONCLUSIONS: This systematic review data suggest that allograft reconstructions in anterior glenohumeral instability could be a viable alternative to similar reconstructions with autografts and provide close clinical/radiological outcomes, at short and mid-term follow-up. Prospective randomized studies are needed to confirm these results.
Authors: Michael J Griesser; Joshua D Harris; Brett W McCoy; Waqas M Hussain; Morgan H Jones; Julie Y Bishop; Anthony Miniaci Journal: J Shoulder Elbow Surg Date: 2013-02 Impact factor: 3.019
Authors: Rozalia Dimitriou; George I Mataliotakis; Antonios G Angoules; Nikolaos K Kanakaris; Peter V Giannoudis Journal: Injury Date: 2011-06-25 Impact factor: 2.586
Authors: Jeroen E Markenstein; Kjell C C J Jaspars; Victor P M van der Hulst; W Jaap Willems Journal: Skeletal Radiol Date: 2014-01-18 Impact factor: 2.199
Authors: Guillaume Villatte; Sally Spurr; Cyrus Broden; Antoine Martins; Roger Emery; Peter Reilly Journal: Int Orthop Date: 2018-05-09 Impact factor: 3.075
Authors: Timothy S Mologne; Matthew T Provencher; Kyle A Menzel; Tyler A Vachon; Christopher B Dewing Journal: Am J Sports Med Date: 2007-08 Impact factor: 6.202