Evaluating Healing of Allograft Tissues in the Shoulder—Cartilage and Bone

Abstract

Glenohumeral bone loss and articular defects are often treated by using osseous or osteoarticular allografts. These aid in glenohumeral joint stability and in reconstruction of the native articular surface. Grafts include those such as iliac crest, coracoid, distal tibia, femoral head, or humeral head, depending on the specific surgical pathology. Articular grafts can be further subdivided into viable or nonviable sources. The outcome of grafts that are implemented for stability could be subject to osteolysis, which may portend a poor clinical outcome and recurrent instability. Similarly, grafts required for reconstruction of the articular surface may undergo avascular necrosis, nonunion, and collapse, rendering them useless. The status of these grafts is best assessed with postoperative imaging modalities, which range from plain film radiography to 3-dimensional computed tomography reconstructions. The purpose of this article is to review the current literature regarding the rate of graft resorption, integration, collapse, and union for each of the grafts mentioned using postoperative imaging.