Distal Tibia Allograft Glenoid Reconstruction in Recurrent Anterior Shoulder Instability: Clinical and Radiographic Outcomes

How to handle minor and major bone loss in the shoulder? Current concepts

“…In contrast, it also might carry the burden of higher complication rate (including superficial infection, superficial vein thrombosis, musculocutaneous neuropraxia, graft non-union, graft malunion graft migration, intra-articular hardware and so on),57 although this finding is not universal 58. Alternative bone block procedures to classically used coracoid transfer have been described (ie, ICBG,34–36 distal tibia allograft59 and distal clavicle allograft60) with promising results, comparable with the Latarjet procedure according to some authors 61 62. As more and more of these data become available over time, future research should further strive to ascertain which patients are best candidates for either procedure, ideally by combining the several factors at play (ie, age, level and type of activity, ethnicity, specific technique used, long-term redislocation/complication rate and so on).…”

Editorial Commentary: Using Bankart “Plus” Techniques to Tackle Anterior Shoulder Instability With Bone Loss: Can Newer Arthroscopic Adjuncts Provide Long-Term Stability?

“…13 Provencher and others went on to support this technique with multiple biomechanical and clinical studies demonstrating the effectiveness of the graft to incorporate and decrease redislocation rates in patients with extreme amounts of glenoid bone loss. [14][15][16][17] Our technique replicated this reconstruction arthroscopically via screw fixation of a distal tibial allograft bone block through the Halifax portal, which avoids any damage to the subscapularis muscle and allows for a Bankart repair, making the graft extra-articular 18 (Fig 1). We choose this adjunct when patients present with recurrent anterior instability and glenoid bone loss greater than 10%.…”

Editorial Commentary: Distal Tibia Allograft as an Option for Glenoid Reconstruction in Recurrent Shoulder Instability—It's All About the Bone?

“…In a retrospective case series titled "Distal Tibia Allograft Glenoid Reconstruction in Recurrent Anterior Shoulder Instability: Clinical and Radiographic Outcomes," Provencher, Frank, Golijanin, Gross, Cole, Verma, and Romeo report on their clinical and radiographic outcomes after using a novel distal tibia allograft (DTA) for anterior glenoid reconstruction. 15 A total of 27 men (67% active military duty) underwent the procedure, with an average follow-up of 45 months, and all but 2 had follow-up computed tomographic scans. American Shoulder and Elbow Surgeons score, Western Ontario Shoulder Instability index, and Single Assessment Numeric Evaluation outcome scores improved postoperatively without any statistically significant decrease in motion, and no patient experienced recurrent instability.…”