Postsurgical glenohumeral anchor arthropathy treated with a fresh distal tibia allograft to the glenoid and a fresh allograft to the humeral head

Abstract

The treatment of extensive glenoid chondral defects in young, active patients remains a challenge. Chondrolysis and extensive chondral defects of the glenohumeral joint in young patients have been reported after shoulder surgery and have been associated with the use of thermal capsulorrhaphy, intra-articular pain pumps, and implanted fixation devices, such as suture anchors. Prominent glenohumeral anchors have been implicated in the early development of postoperative glenohumeral degenerative changes. A proud implant may cause local wear on the glenoid and the humerus, contributing to chondral loss, decreased range of motion, mechanical symptoms, and pain. Recently, a novel treatment of glenoid bone loss has been proposed that uses a distal tibia allograft. As our group described in a previous report, this technique was initially for the treatment of glenohumeral instability secondary to extensive glenoid bone loss. The lateral aspect of the distal tibia has excellent conformity to the radius of curvature of the humeral head and has been used as a fresh allograft for the treatment of glenoid bone loss. Given its successful early outcomes, this technique can potentially have broader applications in glenohumeral pathology. We present the case of a young, active patient with focal but extensive glenohumeral degenerative changes.