Abstract
BackgroundThe present study investigated individualized coracoid osteotomy for 3D congruent arc glenoid reconstruction and evaluated the clinical outcomes in recurrent anterior shoulder dislocation.MethodsFrom January 2005 to July 2015, 78 patients with glenoid defect underwent coracoid and conjoint tendon transposition. The patients were divided into the individualized group (n = 34) and the non-individualized group (n = 44). All patients had CT data to reconstruct the shoulder model using Mimics software. In the individualized group, the individual coracoid osteotomy and bone fixation position parameters were measured from preoperative planification through simulating a 3D congruent arc glenoid reconstruction model. The non-individualized group underwent classic Bristow-Latarjet (B-L) procedure. The postoperative evaluation parameters included 3D congruent arc index, coracoid bone position, shoulder osteoarthritis index (Samilson-Prieto) and shoulder function score (Rowe, Constant-Murley score).ResultsThe mean follow-up time was 51.0 months (ranging from 24 to 146). The individualized group got 3D congruent arc reconstruction of the glenoid by postoperative CT scanning. Bone position was more precise in the individual group than that in the B-L group. There was a lower incidence of shoulder osteoarthritis (Samilson-Prieto) in the individual group compared with that in the B-L group: 0 vs 13.6% (mild 6/44, P = 0.027), respectively. No significant difference was observed between the individual and B-L groups in rate of re-dislocation: 0 vs 4.5% (2/44, P = 0.315), respectively. The postoperative Rowe and Constant score was significantly improved but was not significantly different between the two groups.ConclusionThe individual procedure achieved 3D congruent arc glenoid reconstruction. The clinical effects in patients with medium glenoid defect were good, especially the low incidence of shoulder osteoarthritis in middle-term follow-up.
Highlights
The present study investigated individualized coracoid osteotomy for Three dimension (3D) congruent arc glenoid reconstruction and evaluated the clinical outcomes in recurrent anterior shoulder dislocation
The aim of this study was to assess the efficacy of the individualized and precise surgical procedures, which we considered to achieve good postoperative shoulder stability and low incidence of complications
A total of 93 cases of recurrent anterior shoulder dislocation associated with glenoid bone defect accepted the coracoid and conjoint tendon transposition operation
Summary
The present study investigated individualized coracoid osteotomy for 3D congruent arc glenoid reconstruction and evaluated the clinical outcomes in recurrent anterior shoulder dislocation. Successful treatment for anterior shoulder dislocation with bone defect is a controversial and challenging topic. Using the natural curvature of the subcoracoid to match the glenoid front curve is called the congruent arc coracoid transposition. As one of the hot spots in the study of anterior instability of the shoulder joint, the previous congruent arc was only in the coronal plane but not in the three-dimensional plane [4, 5] and just a smooth increase in the glenoid anterior-posterior diameter. It is necessary to reconstruct the glenoid in a three-dimensional (3D) congruent arc plane
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