Humeral Head Reconstruction With Osteochondral Allograft Transplantation

Saltzman, Bryan M.; Riboh, Jonathan C.; Cole, Brian J.; Yanke, Adam B.

doi:10.1016/j.arthro.2015.03.021

Cited by 80 publications

(77 citation statements)

References 25 publications

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“…15 Furthermore, bony allografts, derived from other joints, have been described as treatment options, including femoral head allografts. 22 Although the remplissage procedure is a viable treatment option, the resulting loss of external rotation has been noted as a concern, especially in throwing athletes. 23,24 Although reconstruction through use of a humeral head allograft has been described as effective for treatment of Hill-Sachs lesions, the graft has limited accessibility and requires more precise size matching.…”

Section: Discussionmentioning

confidence: 99%

“…Non-engaging lesions are considered "on-track" if they fall within the contact zone between the glenoid and humeral head, which results in no engagement with the glenoid rim. 17 To address engaging lesions, several treatment options have been reported including remplissage, [18][19][20][21] reconstruction through use of a humeral head allograft, 22 hemiarthroplasty, and arthroplasty. 15 Furthermore, bony allografts, derived from other joints, have been described as treatment options, including femoral head allografts.…”

Section: Discussionmentioning

confidence: 99%

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Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion

Provencher

Sánchez

Schantz

et al. 2017

Arthroscopy Techniques

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The treatment of recurrent glenohumeral instability, especially with a concomitant bony lesion, remains challenging. This is especially true in the case of posterior instability given its less common incidence. Moreover, the presence of an engaging reverse Hill-Sachs lesion in combination with posterior instability will result in the need for a more aggressive treatment option. In comparison with a Hill-Sachs lesion, a reverse Hill-Sachs lesion features greater chondral deficiency that must be addressed during treatment. We propose the talus allograft as a potential allograft for treatment of an engaging reverse Hill-Sachs lesion. The superior articular surface of the talus may be used to reconstruct the articular surface of the humeral head. In this technical note, we describe our preferred primary technique for treatment of an engaging reverse Hill-Sachs lesion with recurrent glenohumeral instability through use of a fresh osteochondral talus allograft, as well as discuss the advantages and disadvantages of this allograft option.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion

Provencher

Sánchez

Schantz

et al. 2017

Arthroscopy Techniques

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“…Alternatively to the presented combination of a Latarjet procedure and a Hill-Sachs remplissage, other treatment options with use of allo-and autografts have been described to reconstruct humeral head and anterior glenoid defects. [11][12][13] However, many of these procedures are more invasive and associated with fairly high complication rates including graft resorption or necrosis in up to 30% of cases. 11,13 Similar to the presented surgical technique of a Latarjet procedure combined with a Hill-Sachs remplissage, the level of evidence regarding dual bone grafting for BBL in AGI is limited to case reports.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] However, many of these procedures are more invasive and associated with fairly high complication rates including graft resorption or necrosis in up to 30% of cases. 11,13 Similar to the presented surgical technique of a Latarjet procedure combined with a Hill-Sachs remplissage, the level of evidence regarding dual bone grafting for BBL in AGI is limited to case reports. 14 Potential advantages of the combination of a Latarjet procedure and a Hill-Sachs remplissage include the minimally invasive approach as compared with open dual grafting techniques and the reduced risk of graft resorption or necrosis (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Remplissage and Open Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability With Severe Bipolar Bone Loss

Katthagen

Anavian

Tahal

et al. 2016

Arthroscopy Techniques

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Bipolar bone loss in patients with anterior glenohumeral instability is challenging to treat. The goal of the treatment is to restore stability by ensuring that the humeral head remains within the glenoid vault. This can be achieved either with the combination of an arthroscopic Bankart procedure and remplissage (glenoid bone loss <25%), or with a Latarjet procedure (glenoid bone loss >25%). In cases with more severe bipolar bone loss of both the glenoid and the humeral head, the conventional approach has been to lengthen the articular arc of the glenoid and to ignore the Hill-Sachs lesion. However, it has recently been shown that this can still lead to an "off-track" situation with persistent shoulder instability from engagement of the Hill-Sachs on the anterior glenoid. In these cases, the combination of a Hill-Sachs remplissage and the Latarjet procedure can be effective in preventing persistent instability. In this technical note, the surgical technique of an arthroscopic Hill-Sachs remplissage in combination with an open Latarjet procedure is presented.

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“…In addition to coracoid transfer and iliac crest bone grafting procedures for addressing critical glenoid bone loss, several authors have advocated for the use of a distal tibial allograft, citing its excellent articular conformity with the native glenoid ROC 97 98. Additionally, the use of allograft to address large HS lesions has been described 99. Although promising, longer term follow-up will be required to determine the durability of these promising techniques.…”

Section: Future Perspectivesmentioning

confidence: 99%