Arthroscopic iliac crest bone grafting in recurrent anterior shoulder instability: minimum 5-year clinical and radiologic follow-up

Purpose To investigate the clinical and radiologic mid- to long-term results of arthroscopic iliac crest bone-grafting for anatomic glenoid reconstruction in patients with recurrent anterior shoulder instability. Methods Seventeen patients were evaluated after a minimum follow-up of 5 years. Clinica...

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Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2021-01, Vol.29 (1), p.266-274
Main Authors: Boehm, Elisabeth, Minkus, Marvin, Moroder, Philipp, Scheibel, Markus
Format: Article
Language:English
Subjects:
Adolescent
Adult
Arthroscopy - methods
Autografts
Bone grafts
Computed tomography
Female
Follow-Up Studies
Grafting
Grafts
Humans
Iliac crest
Ilium - transplantation
Instability
Joint Instability - diagnostic imaging
Joint Instability - physiopathology
Joint Instability - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Patients
Radiography
Range of Motion, Articular
Scapula - diagnostic imaging
Scapula - surgery
Shoudler
Shoulder
Shoulder Dislocation - diagnostic imaging
Shoulder Dislocation - physiopathology
Shoulder Dislocation - surgery
Shoulder Joint - diagnostic imaging
Shoulder Joint - physiopathology
Shoulder Joint - surgery
Stability
Stability analysis
Substitute bone
Surgery
Tomography, X-Ray Computed
Transplantation, Autologous
Trauma
Young Adult
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Summary:Purpose To investigate the clinical and radiologic mid- to long-term results of arthroscopic iliac crest bone-grafting for anatomic glenoid reconstruction in patients with recurrent anterior shoulder instability. Methods Seventeen patients were evaluated after a minimum follow-up of 5 years. Clinical [range of motion, subscapularis tests, apprehension sign, Subjective Shoulder Value (SSV), Constant Score (CS), Rowe Score (RS), Walch Duplay Score (WD), Western Ontario Shoulder Instability Index (WOSI)], and radiologic [X-ray (true a.p., Bernageau and axillary views) and computed tomography (CT)] outcome parameters were assessed. Results Fourteen patients [mean age 31.1 (range 18–50) years] were available after a follow-up period of 78.7 (range 60–110) months. The SSV averaged 87 (range 65–100) %, CS 94 (range 83–100) points, RS 89 (range 30–100) points, WD 87 (range 25–100) points, and WOSI 70 (range 47–87) %. The apprehension sign was positive in two patients (14%). One patient required an arthroscopic capsular plication due to a persisting feeling of instability, while the second patient experienced recurrent dislocations after a trauma, but refused revision surgery. CT imaging showed a significant increase of the glenoid index from preoperative 0.8 ± 0.04 (range 0.7–0.8) to 1.0 ± 0.11 (range 0.8–1.2) at the final follow-up ( p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-020-05986-7