Outcomes of Distal Tibia Allograft Reconstruction For Recurrent Anterior Shoulder Instability

Abstract

IntroductionTo assess the clinical and radiographic outcomes of patients with recurrent anterior shoulder instability treated with fresh distal tibia allograft (DTA) glenoid reconstruction.MethodsConsecutive patients with a minimum 15% glenoid bone loss with recurrent anterior instability underwent glenoid bone reconstruction using a fresh DTA were reviewed. Patients were excluded for hyperlaxity or neurologic injury. Patients were evaluated with various clinical outcomes assessments at a minimum of two years and computed tomography (CT) at a minimum of six months postoperatively. All CT scans were graded for: 1) overall allograft healing to the native glenoid; 2) angle of allograft relative to the native glenoid (allograft angle); and 3) amount of allograft lysis. Statistical analysis was performed with paired T-tests, with PResultsA total of 20 patients (average age 31 ± 5 years) with an average follow-up of 45 months (range, 30-66) were included. There were statistically significant improvements in pre-operative to post-operative ASES (63 to 91, PConclusionAt an average follow-up of nearly 4 years, fresh DTA reconstruction for recurrent anterior shoulder instability results in a clinically stable joint with excellent clinical outcomes and minimal graft reabsorption. Optimal allograft placement resulted in superior bony incorporation with the native glenoid. IntroductionTo assess the clinical and radiographic outcomes of patients with recurrent anterior shoulder instability treated with fresh distal tibia allograft (DTA) glenoid reconstruction. To assess the clinical and radiographic outcomes of patients with recurrent anterior shoulder instability treated with fresh distal tibia allograft (DTA) glenoid reconstruction. MethodsConsecutive patients with a minimum 15% glenoid bone loss with recurrent anterior instability underwent glenoid bone reconstruction using a fresh DTA were reviewed. Patients were excluded for hyperlaxity or neurologic injury. Patients were evaluated with various clinical outcomes assessments at a minimum of two years and computed tomography (CT) at a minimum of six months postoperatively. All CT scans were graded for: 1) overall allograft healing to the native glenoid; 2) angle of allograft relative to the native glenoid (allograft angle); and 3) amount of allograft lysis. Statistical analysis was performed with paired T-tests, with P Consecutive patients with a minimum 15% glenoid bone loss with recurrent anterior instability underwent glenoid bone reconstruction using a fresh DTA were reviewed. Patients were excluded for hyperlaxity or neurologic injury. Patients were evaluated with various clinical outcomes assessments at a minimum of two years and computed tomography (CT) at a minimum of six months postoperatively. All CT scans were graded for: 1) overall allograft healing to the native glenoid; 2) angle of allograft relative to the native glenoid (allograft angle); and 3) amount of allograft lysis. Statistical analysis was performed with paired T-tests, with P ResultsA total of 20 patients (average age 31 ± 5 years) with an average follow-up of 45 months (range, 30-66) were included. There were statistically significant improvements in pre-operative to post-operative ASES (63 to 91, P A total of 20 patients (average age 31 ± 5 years) with an average follow-up of 45 months (range, 30-66) were included. There were statistically significant improvements in pre-operative to post-operative ASES (63 to 91, P ConclusionAt an average follow-up of nearly 4 years, fresh DTA reconstruction for recurrent anterior shoulder instability results in a clinically stable joint with excellent clinical outcomes and minimal graft reabsorption. Optimal allograft placement resulted in superior bony incorporation with the native glenoid. At an average follow-up of nearly 4 years, fresh DTA reconstruction for recurrent anterior shoulder instability results in a clinically stable joint with excellent clinical outcomes and minimal graft reabsorption. Optimal allograft placement resulted in superior bony incorporation with the native glenoid.