Autologous free iliac crest bone grafting of glenoid through the rotator interval using double-barrelled cannula


Creative Commons License

Gürsan O., Eroğlu O. N., Türemiş C., Akdoğan E. K., Şevik K., Hapa O.

European Journal of Orthopaedic Surgery and Traumatology, vol.32, no.2, pp.279-286, 2022 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 2
  • Publication Date: 2022
  • Doi Number: 10.1007/s00590-021-02965-7
  • Journal Name: European Journal of Orthopaedic Surgery and Traumatology
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.279-286
  • Keywords: Anterior shoulder instability, Arthroscopy, Iliac crest bone block, Subscapularis
  • Dokuz Eylül University Affiliated: Yes

Abstract

© 2021, The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.Purpose: The primary aim of this study is to prove that reconstructing the anterior glenoid defect with iliac crest graft arthroscopically using double-barrelled cannula through the rotator interval is safe and prevents both recurrence of instability and the neurovascular injury because subscapularis muscle is not split and procedure is far away from important structures. Methods: Thirteen patients with anterior shoulder instability and engaging Hill-Sachs lesion were reviewed after arthroscopic reconstruction of the anterior glenoid with iliac crest autogenous graft. Patient satisfaction and Western Ontario İnstability Score (WOSI) were evaluated on clinical examination. Computed tomography was used to analyse graft position on sagittal and axial planes. Results: The mean follow-up was 28.7 months (SD 7.1), and age at surgery was 31 years (21 to 64 years). Post-operatively there was only one dislocation due to trauma. There was statistically significant improvement of WOSI scores (p: 0.001). There was not any neurological injury. Graft position on the axial plane was described as flush in 5 cases (41%), lateral in 2 (16%), too lateral in one (8%) and medial in 4 of the cases (33%). Graft position could be accepted as high in only three patients (23%). Conclusion: Arthroscopic reconstruction of glenoid defect using autogenous iliac bone graft, through rotator interval, without splitting subscapularis is safe and effective without any neurological injury, producing substantial graft position and good functional outcomes in patients.