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Bone grafts used for arthroscopic glenoid reconstruction restore the native glenoid anatomy

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Recurrent anterior instability of the glenohumeral joint is a demanding condition, especially in cases of glenoid bone loss. Various treatment options have been described, such as arthroscopic grafting techniques and the Latarjet procedure. In this study, the degree to which an arthroscopically applied iliac crest graft restores the glenoid anatomy was evalutated.

Methods

Nine patients (three women and six men) with an average age of 31 ± 9 years (21–46 years) who were treated with an arthroscopic iliac crest graft technique were included in this study. After a mean follow up of 34 ± 10 months (19–50 months) after the procedure, MRI scans of both shoulders were performed and the glenoid width, Glenoid Index (GI), Pixel Signal intensity (PSI), thickness of the tissue covering the articular aspect of the graft, inclination, version, concavity and balance stability angle were measured.

Results

All scans showed the cultivation of tissue on the graft, which visually resembled the cartilage of the native ipsilateral glenoid. Additionally, reshaping of the graft to repair the glenoid configuration could be observed. Glenoid width (p = 0.022) and GI (p < 0.001) increased significantly through surgery. The tissue examined on the graft showed a significant pixel intensity gap (p = 0.017) but comparable thickness (n.s.) in relation to native cartilage. The remaining parameters did not differ significantly between both shoulders.

Conclusion

In the cohort presented, iliac crest grafts were able to restore the glenoid configuration, and the glenoid was re-shaped to its native contour. Additionally, cartilage-like scar tissue with similar thickness as healthy cartilage was formed on the articular side of the graft. These results suggest that glenoid reconstruction is not only important for prevention of recurrence, but also for restoration of the native glenoid anatomy.

Level of evidence

Level III—retrospective cohort study.

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Acknowledgements

We thank Mrs Bettina Eßer from the Department of Diagnostic Radiology, St. Vinzenz hospital Düsseldorf, for her technical advice while conducting the study.

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Authors and Affiliations

  1. Department of Rheumatology and Arthroscopy, Marienkrankenhaus Düsseldorf-Kaiserswerth, An St Swidbert 17, Düsseldorf, Germany

    Benjamin Bockmann, Arne Johannes Venjakob, Frank Reichwein, Marthe Hagenacker & Wolfgang Nebelung

  2. Department of Diagnostic Radiology, St. Vinzenz Hospital, Schloßstraße 85, Düsseldorf, Germany

    Rolf Gebing

Authors
  1. Benjamin Bockmann
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  2. Arne Johannes Venjakob
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  3. Rolf Gebing
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  4. Frank Reichwein
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  5. Marthe Hagenacker
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  6. Wolfgang Nebelung
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Contributions

BB conducted the measurements, wrote the manuscript and calculated the statistics. AJV participated in the study’s design and coordination and helped to draft the manuscript. RG performed the MRI scans. FR participated in the study’s design and coordination and helped to draft the manuscript. MH helped to draft the manuscript and was involved in data collection. WN conceived of the study, and participated in its design and coordination and helped to draft the manuscript.

Corresponding author

Correspondence to Benjamin Bockmann.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical approval

The study was approved by the ethics committee of the Medical Association of North Rhine (file number 2016324).

Informed consent

All patients gave written informed consent prior to inclusion.

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Cite this article

Bockmann, B., Venjakob, A.J., Gebing, R. et al. Bone grafts used for arthroscopic glenoid reconstruction restore the native glenoid anatomy. Knee Surg Sports Traumatol Arthrosc 26, 299–305 (2018). https://doi.org/10.1007/s00167-017-4757-6

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  • DOI: https://doi.org/10.1007/s00167-017-4757-6

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