Open anatomical glenoid reconstruction with an iliac crest bone autograft effectively resolves off-track Hill-Sachs lesions to on-track lesions
- 05.07.2021
- Orthopaedic Surgery
Erschienen in:
- Verfasst von
- Joel Locher
- Umile Giuseppe Longo
- Francesco Pirato
- Roman Susdorf
- Heath B. Henninger
- Thomas Suter
- Erschienen in
- Archives of Orthopaedic and Trauma Surgery | Ausgabe 1/2023
Abstract
Introduction
The purpose of this study was to determine if “off-track” Hill-Sachs lesions in patients with dynamic anteroinferior instability were transformed into “on-track” lesions using iliac bone autografts with screw fixation. The secondary purpose was to observe if postoperative bony remodeling would occur over time, resulting in recurrent “off-track” Hill-Sachs lesions with corresponding instability.
Materials and methods
We retrospectively reviewed clinical and CT records of 8 patients with an “off-track” Hill-Sachs lesion who underwent open anatomical glenoid reconstruction with an iliac crest bone autograft. Hill-Sachs lesions, glenoid track widths, and glenoid surface areas were measured on a preoperative and two postoperative (6 weeks, ≥ 2 years) 3D-CT models to determine graft resorption over time. All patients were available for postoperative clinical and CT final follow-up 3 years (2–4 years) postoperatively.
Results
In all patients, the Hill-Sachs lesions were “on-track” 6 weeks postoperatively and remained “on-track” at final-follow-up. Compared to preoperative values, the glenoid track width and glenoid surface area both were higher 6 weeks postoperatively (p < 0.001 and p = 0.023, respectively) and at final follow-up (p < 0.001 and p = 0.023, respectively). Whereas the glenoid track width between 6 weeks and final follow-up showed no decrease (p = 0.234), glenoid surface area tended to decrease (p = 0.055). The median SSV was 93 points (85–95 points), the Rowe score 90 points (80–100 points) and the WOSI 1980 points (1783–2067 points) at final follow-up. No recurrent dislocations or subluxations were observed.
Conclusions
An open anatomical glenoid reconstruction with an iliac crest bone autograft technique using screw fixation effectively transformed “off-track” Hill-Sachs lesions to “on-track” lesions, resulting in good short-term clinical outcomes. Whereas glenoid surface area tended to be reduced by bony remodeling processes over time, the glenoid track width did not decrease at final follow-up and consequently no recurrence of “off-track” lesions occurred.
Level of evidence
Case series; Level of evidence, IV.
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- Titel
- Open anatomical glenoid reconstruction with an iliac crest bone autograft effectively resolves off-track Hill-Sachs lesions to on-track lesions
- Verfasst von
-
Joel Locher
Umile Giuseppe Longo
Francesco Pirato
Roman Susdorf
Heath B. Henninger
Thomas Suter
- Publikationsdatum
- 05.07.2021
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Archives of Orthopaedic and Trauma Surgery / Ausgabe 1/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916 - DOI
- https://doi.org/10.1007/s00402-021-04016-6
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