Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case Series
Purpose: To report the clinical history and preliminary outcomes of patients who underwent posterior glenoid reconstruction using a distal tibial allograft (DTA) for the management of posterior shoulder instability with glenoid bone loss. Methods: Patients who underwent posterior shoulder stabilizat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X20300705 |
| _version_ | 1818641981813817344 |
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| author | Ron Gilat, M.D. Eric D. Haunschild, B.S. Tracy Tauro, B.S., B.A. Aghogho Evuarherhe, B.S. Michael C. Fu, M.D. Anthony Romeo, M.D. Nikhil Verma, M.D. Brian J. Cole, M.D., M.B.A. |
| author_facet | Ron Gilat, M.D. Eric D. Haunschild, B.S. Tracy Tauro, B.S., B.A. Aghogho Evuarherhe, B.S. Michael C. Fu, M.D. Anthony Romeo, M.D. Nikhil Verma, M.D. Brian J. Cole, M.D., M.B.A. |
| author_sort | Ron Gilat, M.D. |
| collection | DOAJ |
| description | Purpose: To report the clinical history and preliminary outcomes of patients who underwent posterior glenoid reconstruction using a distal tibial allograft (DTA) for the management of posterior shoulder instability with glenoid bone loss. Methods: Patients who underwent posterior shoulder stabilization with a DTA in our institution between 2011 and 2019 were retrospectively reviewed. Demographic characteristics, operative reports, and clinical and functional outcomes were recorded. Outcomes included postoperative range of motion (ROM), recurrent instability, complications, and revision surgery. All patients underwent at least 1 year of follow-up, except 2 patients who underwent revision surgery. Preoperative and postoperative ROM was compared using the 2-tailed Student t test for paired samples. Results: Ten patients who underwent DTA augmentation for posterior instability were included, comprising 2 female and 8 male patients with an average age of 24 years (range, 17-35 years). Five patients had a prior sports-related traumatic event, and 2 patients had a seizure disorder. Seven patients had undergone a prior stabilization procedure. The average reverse bony Bankart lesion was 26% of the glenoid diameter. Concomitant procedures included 4 capsular repairs, 2 labral repairs, 2 capsular plications, and 1 repair for humeral avulsion of the glenohumeral ligament. One patient reported recurrent instability after surgery. Two patients underwent revision surgery, with one removal of symptomatic hardware and one early revision owing to screw penetration into the glenoid. There was no significant difference in preoperative versus postoperative ROM. Conclusions: Posterior shoulder instability with significant bony deficiency can be managed using DTA augmentation with good outcomes and a reasonable complication rate in these challenging cases. Level of Evidence: Level IV, case series. |
| first_indexed | 2024-12-16T23:35:48Z |
| format | Article |
| id | doaj.art-607fe592655e43b8b0d796b21fdf0d7b |
| institution | Directory Open Access Journal |
| issn | 2666-061X |
| language | English |
| last_indexed | 2024-12-16T23:35:48Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj.art-607fe592655e43b8b0d796b21fdf0d7b2022-12-21T22:11:45ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2020-12-0126e743e752Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case SeriesRon Gilat, M.D.0Eric D. Haunschild, B.S.1Tracy Tauro, B.S., B.A.2Aghogho Evuarherhe, B.S.3Michael C. Fu, M.D.4Anthony Romeo, M.D.5Nikhil Verma, M.D.6Brian J. Cole, M.D., M.B.A.7Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.; Department of Orthopaedic Surgery, Shamir Medical Center and Tel Aviv University, Tel Aviv, IsraelMidwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.; Address correspondence to Brian J. Cole, M.D., M.B.A., Midwest Orthopaedics at Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, U.S.A.Purpose: To report the clinical history and preliminary outcomes of patients who underwent posterior glenoid reconstruction using a distal tibial allograft (DTA) for the management of posterior shoulder instability with glenoid bone loss. Methods: Patients who underwent posterior shoulder stabilization with a DTA in our institution between 2011 and 2019 were retrospectively reviewed. Demographic characteristics, operative reports, and clinical and functional outcomes were recorded. Outcomes included postoperative range of motion (ROM), recurrent instability, complications, and revision surgery. All patients underwent at least 1 year of follow-up, except 2 patients who underwent revision surgery. Preoperative and postoperative ROM was compared using the 2-tailed Student t test for paired samples. Results: Ten patients who underwent DTA augmentation for posterior instability were included, comprising 2 female and 8 male patients with an average age of 24 years (range, 17-35 years). Five patients had a prior sports-related traumatic event, and 2 patients had a seizure disorder. Seven patients had undergone a prior stabilization procedure. The average reverse bony Bankart lesion was 26% of the glenoid diameter. Concomitant procedures included 4 capsular repairs, 2 labral repairs, 2 capsular plications, and 1 repair for humeral avulsion of the glenohumeral ligament. One patient reported recurrent instability after surgery. Two patients underwent revision surgery, with one removal of symptomatic hardware and one early revision owing to screw penetration into the glenoid. There was no significant difference in preoperative versus postoperative ROM. Conclusions: Posterior shoulder instability with significant bony deficiency can be managed using DTA augmentation with good outcomes and a reasonable complication rate in these challenging cases. Level of Evidence: Level IV, case series.http://www.sciencedirect.com/science/article/pii/S2666061X20300705 |
| spellingShingle | Ron Gilat, M.D. Eric D. Haunschild, B.S. Tracy Tauro, B.S., B.A. Aghogho Evuarherhe, B.S. Michael C. Fu, M.D. Anthony Romeo, M.D. Nikhil Verma, M.D. Brian J. Cole, M.D., M.B.A. Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case Series Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case Series |
| title_full | Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case Series |
| title_fullStr | Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case Series |
| title_full_unstemmed | Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case Series |
| title_short | Distal Tibial Allograft Augmentation for Posterior Shoulder Instability Associated With Glenoid Bony Deficiency: A Case Series |
| title_sort | distal tibial allograft augmentation for posterior shoulder instability associated with glenoid bony deficiency a case series |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X20300705 |
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