Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss
Glenoid bone loss is a significant risk factor for failure after arthroscopic shoulder stabilization. Multiple options are available to reconstruct this bone loss, including coracoid transfer, iliac crest bone graft, and osteoarticular allograft. Each technique has strengths and weaknesses. Coracoid...
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| Format: | Article |
| Language: | English |
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Elsevier
2014-08-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221262871400053X |
| _version_ | 1819002675554942976 |
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| author | John M. Tokish, M.D. Kelly Fitzpatrick, D.O. Jay B. Cook, M.D. William J. Mallon, M.D. |
| author_facet | John M. Tokish, M.D. Kelly Fitzpatrick, D.O. Jay B. Cook, M.D. William J. Mallon, M.D. |
| author_sort | John M. Tokish, M.D. |
| collection | DOAJ |
| description | Glenoid bone loss is a significant risk factor for failure after arthroscopic shoulder stabilization. Multiple options are available to reconstruct this bone loss, including coracoid transfer, iliac crest bone graft, and osteoarticular allograft. Each technique has strengths and weaknesses. Coracoid grafts are limited to anterior augmentation and, along with iliac crest, do not provide an osteochondral reconstruction. Osteochondral allografts do provide a cartilage source but are challenged by the potential for graft rejection, infection, cost, and availability. We describe the use of a distal clavicular osteochondral autograft for bony augmentation in cases of glenohumeral instability with significant bone loss. This graft has the advantages of being readily available and cost-effective, it provides an autologous osteochondral transplant with minimal donor-site morbidity, and it can be used in both anterior and posterior bone loss cases. The rationale and technical aspects of arthroscopic performance will be discussed. Clinical studies are warranted to determine the outcomes of the use of the distal clavicle as a graft in shoulder instability. |
| first_indexed | 2024-12-20T23:08:53Z |
| format | Article |
| id | doaj.art-1ff5590129b04559ab2a7829efeaf6ab |
| institution | Directory Open Access Journal |
| issn | 2212-6287 |
| language | English |
| last_indexed | 2024-12-20T23:08:53Z |
| publishDate | 2014-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj.art-1ff5590129b04559ab2a7829efeaf6ab2022-12-21T19:23:48ZengElsevierArthroscopy Techniques2212-62872014-08-0134e475e481Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone LossJohn M. Tokish, M.D.0Kelly Fitzpatrick, D.O.1Jay B. Cook, M.D.2William J. Mallon, M.D.3Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, U.S.A.; Address correspondence to John M. Tokish, M.D., Steadman Hawkins Clinic of the Carolinas, 200 Patewood Ave, Suite C100, Greenville, SC, 29615, U.S.A.Department of Surgery, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.Department of Surgery, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.Triangle Orthopaedics, Durham, North Carolina, U.S.A.Glenoid bone loss is a significant risk factor for failure after arthroscopic shoulder stabilization. Multiple options are available to reconstruct this bone loss, including coracoid transfer, iliac crest bone graft, and osteoarticular allograft. Each technique has strengths and weaknesses. Coracoid grafts are limited to anterior augmentation and, along with iliac crest, do not provide an osteochondral reconstruction. Osteochondral allografts do provide a cartilage source but are challenged by the potential for graft rejection, infection, cost, and availability. We describe the use of a distal clavicular osteochondral autograft for bony augmentation in cases of glenohumeral instability with significant bone loss. This graft has the advantages of being readily available and cost-effective, it provides an autologous osteochondral transplant with minimal donor-site morbidity, and it can be used in both anterior and posterior bone loss cases. The rationale and technical aspects of arthroscopic performance will be discussed. Clinical studies are warranted to determine the outcomes of the use of the distal clavicle as a graft in shoulder instability.http://www.sciencedirect.com/science/article/pii/S221262871400053X |
| spellingShingle | John M. Tokish, M.D. Kelly Fitzpatrick, D.O. Jay B. Cook, M.D. William J. Mallon, M.D. Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss Arthroscopy Techniques |
| title | Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss |
| title_full | Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss |
| title_fullStr | Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss |
| title_full_unstemmed | Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss |
| title_short | Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss |
| title_sort | arthroscopic distal clavicular autograft for treating shoulder instability with glenoid bone loss |
| url | http://www.sciencedirect.com/science/article/pii/S221262871400053X |
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