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Archives of Orthopaedic and Trauma Surgery

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10.06.2020 | Arthroscopy and Sports Medicine

Use of allograft to reconstruct anterior bony glenoid defect in chronic glenohumeral instability: a systematic review

verfasst von: Guillaume Villatte, Antoine Martins, Roger Erivan, Bruno Pereira, Stéphane Descamps, Stéphane Boisgard

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 10/2020

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Abstract

Introduction

Bone-block procedures are well-established in anterior chronic shoulder instability treatment. Autograft with the coracoid process (Bristow-Latarjet procedures) and iliac crest (Eden-Hybbinette) are the most frequent source of bone but the use of allograft is also possible. The objective of this review is to assess clinical and radiographic outcomes after bony allograft reconstruction in anterior glenohumeral instability.

Material and methods

Medline, Cochrane, Embase databases were searched for studies reporting on bone allograft reconstruction in anterior glenohumeral instability with glenoid defect. We conducted a systematic review of studies with all levels of evidence reporting on clinical or radiological outcomes or both. Level of evidence: IV.

Results

Ten studies met the inclusion criteria for the review; 283 shoulders were included with a mean age of 26 years (17–63) and mean follow-up of 34 months (4–168). Glenoid reconstruction was performed using bone from different source: femoral head (1 study), distal tibia allograft (5 studies), and iliac crest (4 studies). Allografts were fresh in 4 studies, demineralized in 2 studies, and freeze-dried after sterilization in 1 study. All scores performed in the different studies increased between pre-operative and post-operative evaluations (mean + 36.8 points for the ASES). Global rate of recurrence was 3.9% (11 patients) (0–11%), comprising 6 cases of dislocation (2.1%) and 5 subluxations (1.8%). Allograft healing occurred in 93.5% of cases.

Conclusions

This systematic review data suggest that allograft reconstructions in anterior glenohumeral instability could be a viable alternative to similar reconstructions with autografts and provide close clinical/radiological outcomes, at short and mid-term follow-up. Prospective randomized studies are needed to confirm these results.

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Titel: Use of allograft to reconstruct anterior bony glenoid defect in chronic glenohumeral instability: a systematic review
verfasst von: Guillaume Villatte
Antoine Martins
Roger Erivan
Bruno Pereira
Stéphane Descamps
Stéphane Boisgard
Publikationsdatum: 10.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 10/2020
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03511-6

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Use of allograft to reconstruct anterior bony glenoid defect in chronic glenohumeral instability: a systematic review

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