Risk Factors of Graft Resorption after Arthroscopic Autologous Scapular Spine Bone Graft for Recurrent Shoulder Instability

Abstract

Objective To analyze if general factors such as age, gender, dominant side, fasting blood sugar level, BMI (body mass index), smoking, and drinking play a role in graft resorption after arthroscopic autologous scapular spine bone grafting. Methods From July 2016 to August 2018, patients who were diagnosed with anterior shoulder instability with subcritical bone loss (10%–15%) and underwent arthroscopic autologous scapular spine bone graft transplant were retrospectively reviewed and enrolled in this study. The age, gender, dominant side, fasting blood sugar level, BMI, smoking, and drinking conditions of the enrolled patients were recorded. The graft resorption rate at postoperative 1 year was also measured on three‐dimensional computed tomography (3D‐CT) scans. The Pearson test and the Spearman test were used to identify any significant correlation between the general factors and graft resorption rate. Results A total of 27 patients who underwent arthroscopic autologous scapular spine bone graft for recurrent shoulder instability qualified and were included in this study. There were 20 males and seven females, the mean age was 30.8 ± 9.4 years, the mean follow‐up time was 29.3 months (range, 25–39 months), during which no severe complications such as infection, neurovascular injury, or re‐dislocation were observed. The bone graft healed in all cases, the mean healing time was 2.6 ± 0.5 months (range, 2–3 months). At the last follow‐up, the mean Constant–Murley score was 89.74 ± 3.71, the mean Disabilities of Arm, Shoulder and Hand (DASH) score was 9.77 ± 5.31, and the mean visual analogue score (VAS) was 0.74 ± 0.64. The apprehension test was all negative at final follow‐up. The fasting blood sugar level was 4.78 ± 0.42 mmol/L, BMI was 23.70 ± 4.70. Five patients were “smoking” and 22 “non‐smoking”, four patients were “drinking” and 23 were “non‐drinking.” The graft resorption rate at postoperative 1 year was 19.4% ± 7.5%. The Pearson test and the Spearman test showed no significant correlation between age, gender, dominant side, fasting blood sugar level, BMI, smoking, drinking, and graft resorption rate. Conclusion Age, gender, dominant side, fasting blood sugar level, BMI, smoking, and drinking were not significantly correlated with graft resorption after the arthroscopic autologous scapular spine bone graft for recurrent shoulder instability.

Graft Resorption After Posterior Distal Tibial Allograft Augmentation for Posterior Shoulder Instability

“…This finding is potentially the result of stress shielding of an oversized and/or supraequitorial area of graft that received less load than the inferior portion of the graft. This resorption is consistent with Wolff’s law and prior hypotheses regarding lack of mechanical stimuli being a primary cause of glenoid bone graft resorption 3,19 . It is worth noting that graft positioning on the posterior glenoid in an arthroscopic setting is dependent on acromial geometry, with acromion posterior overhang complicating orthogonal access and body habitus compounding any error in an posterior portal location.…”

“…However, resorption has not been described in the setting of arthroscopic DTA for posterior instability. Both biological factors, such as incomplete revascularization and immunological response, and biomechanical factors, such as decreased mechanical stimulus, can contribute to resorption 2-4 . An initial report of graft resorption after arthroscopic DTA for anterior instability cited a rate of 3% 5 .…”

Novel Claw‐shaped Bone Plate in Complex Unstable Scapular Neck and Body Fractures: Comparison with Reconstruction Locking Plate

“…In recent years, arthroscopic treatment of scapular fractures as a new treatment has achieved satisfactory results 36 . These include type IA scapular glenoid fractures 37 .…”

Morphometric and Biomechanical Comparison of the Scapular Spine and Coracoid Graft in Anterior Shoulder Instability

“…37,46 Successful clinical outcomes of scapular spine grafts in glenoid reconstruction have been reported in both open and arthroscopic surgery. 16,26,44,52,55 However, few studies have focused on biomechanical and morphometric characteristics. Investigation of scapular spine biomechanics is necessary to help determine the safety and strength of screw placement.…”