Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 21, Issue 2, pp 445–449

Reconstruction of posterior glenoid deficiency using distal tibial osteoarticular allograft

  • Peter J. Millett
  • Jean-Yves Schoenahl
  • Bradley Register
  • Trevor R. Gaskill
  • Derek. F. P. van Deurzen
  • Frank Martetschläger
Shoulder

Abstract

Posterior shoulder instability with glenoid deficiency is a rare entity and its surgical treatment is challenging. Reconstructive techniques have focused on extra-articular structural bone transfer that obstructs humeral translation and thereby prevents glenohumeral dislocation. However, long-term results are not as promising. In this report, the authors describe a technique for anatomic posterior glenoid reconstruction using an osteoarticular distal tibia allograft in two patients including their outcomes after 2 years.

Level of evidence IV.

Keywords

Glenoid bone loss Posterior shoulder instability Bone deficiency Allograft Distal tibia 

References

  1. 1.
    Bahk M, Keyurapan E, Tasaki A, Sauers EL, McFarland EG (2007) Laxity testing of the shoulder: a review. Am J Sports Med 35(1):131–144PubMedCrossRefGoogle Scholar
  2. 2.
    Barbier O, Ollat D, Marchaland JP, Versier G (2009) Iliac bone-block autograft for posterior shoulder instability. Orthop Traumatol Surg Res 95(2):100–107PubMedCrossRefGoogle Scholar
  3. 3.
    Barker JU, Gardner MJ, Boraiah S, Kelly BT, Lane JM, Lorich DG (2008) Complete bony union achieved after arthrodesis of native glenoid and acromion to an allograft proximal humerus: a case report. J Should Elb Surg 17(2):e19–e22CrossRefGoogle Scholar
  4. 4.
    Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 16(7):677–694PubMedCrossRefGoogle Scholar
  5. 5.
    Burkhart SS, Debeer JF, Tehrany AM, Parten PM (2002) Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 18(5):488–491PubMedCrossRefGoogle Scholar
  6. 6.
    Kouvalchouk JF, Coudert X, Watin Augouard L, Da Silva Rosa R, Paszkowski A (1993) Treatment of posterior instability of the shoulder joint using an acromial stop with a pediculated deltoid flap. Rev Chir Orthop Repar Appar Mot 79(8):661–665Google Scholar
  7. 7.
    Lo IK, Parten PM, Burkhart SS (2004) The inverted pear glenoid: an indicator of significant glenoid bone loss. Arthroscopy 20(2):169–174PubMedCrossRefGoogle Scholar
  8. 8.
    Meuffels DE, Schuit H, van Biezen FC, Reijman M, Verhaar JA (2010) The posterior bone block procedure in posterior shoulder instability: a long-term follow-up study. J Bone Joint Surg Br 92(5):651–655PubMedCrossRefGoogle Scholar
  9. 9.
    Millett PJ, Clavert P, Hatch GF 3rd, Warner JJ (2006) Recurrent posterior shoulder instability. J Am Acad Orthop Surg 14(8):464–476PubMedGoogle Scholar
  10. 10.
    Mowery CA, Garfin SR, Booth RE, Rothman RH (1985) Recurrent posterior dislocation of the shoulder: treatment using a bone block. J Bone Joint Surg Am 67(5):777–781PubMedGoogle Scholar
  11. 11.
    Provencher MT, Ghodadra N, LeClere L, Solomon DJ, Romeo AA (2009) Anatomic osteochondral glenoid reconstruction for recurrent glenohumeral instability with glenoid deficiency using a distal tibia allograft. Arthroscopy 25(4):446–452PubMedCrossRefGoogle Scholar
  12. 12.
    Servien E, Walch G, Cortes ZE, Edwards TB, O’Connor DP (2007) Posterior bone block procedure for posterior shoulder instability. Knee Surg Sports Traumatol Arthrosc 15(9):1130–1136PubMedCrossRefGoogle Scholar
  13. 13.
    Sirveaux F, Leroux J, Roche O, Gosselin O, De Gasperi M, Mole D (2004) Surgical treatment of posterior instability of the shoulder joint using an iliac bone block or an acromial pediculated bone block: outcome in eighteen patients. Rev Chir Orthop Repar Appar Mot 90(5):411–419CrossRefGoogle Scholar
  14. 14.
    Weng PW, Shen HC, Lee HH, Wu SS, Lee CH (2009) Open reconstruction of large bony glenoid erosion with allogeneic bone graft for recurrent anterior shoulder dislocation. Am J Sports Med 37(9):1792–1797PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Peter J. Millett
    • 1
  • Jean-Yves Schoenahl
    • 1
  • Bradley Register
    • 2
  • Trevor R. Gaskill
    • 3
  • Derek. F. P. van Deurzen
    • 4
  • Frank Martetschläger
    • 1
    • 5
  1. 1.The Steadman ClinicSteadman Philippon Research InstituteVailUSA
  2. 2.Athens Orthopedic ClinicAthensUSA
  3. 3.Bone and Joints Sports Medicine InstituteNaval Medical Center PortsmouthPortsmouthUSA
  4. 4.Onze Lieve Vrouwe Gasthuis (OLVG)AmsterdamThe Netherlands
  5. 5.Department of Orthopaedic Sports Medicine, University Hospital Rechts der IsarMunich Technical UniversityMunichGermany

Personalised recommendations