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An arthroscopic bone block procedure is effective in restoring stability, allowing return to sports in cases of glenohumeral instability with glenoid bone deficiency

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

A group of patients affected by bone loss in the context of recurrent anterior shoulder instability were treated arthroscopically with a modified Eden-Hybinette technique since 2005. The last modification was made in 2013, consisting of fixation using a pair of specifically designed double round Endobuttons, which secure the bone graft to the glenoid rim placed through a guide. This report describes patients operated on after this last modification. No reports have described the results of this technique, and the purpose of this study was to assess early clinical and radiological results of an arthroscopic bone block procedure with double round Endobutton fixation. We hypothesized that this technique would restore shoulder stability in patients with anteroinferior glenohumeral instability with glenoid bone deficit, with excellent clinical and radiological results.

Methods

The clinical and radiological efficacy of this procedure was retrospectively evaluated in 26 patients with an average follow-up of 29.6 months (range 24–33 months).

Results

At minimum 2-year follow-up, we had no recurrent anterior dislocations, excellent clinical results [average Walch-Duplay score 93.2, (SD 7.8); average Rowe score, 96.4 (SD 6.5); average SSV, 87.4 (SD 12.1); satisfaction rate, 88.5%; average loss of external rotation, 4.4° (SD 8.7°)] optimal graft positioning, and a healing rate of 92.3% on computed tomography scan.

Conclusions

Arthroscopic bone block grafting combined with a standard Bankart repair restored shoulder stability in patients with anteroinferior glenohumeral instability with glenoid bone deficit, with excellent clinical and radiological results. This procedure did not substantially limit external rotation, allowing a high rate of return to sports even among competitive, overhead, and “at risk” athletes.

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Acknowledgements

We thank Peter Mittwede, MD, Ph.D, from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

Dr. Ettore Taverna receives royalties and fees for consulting from Smith and Nephew Inc. All the other authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Authors and Affiliations

  1. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    Ettore Taverna, Carlo Perfetti, Luca Maria Sconfienza & Vincenzo Guarrella

  2. Servizio di Chirurgia dell’Arto Superiore, OBV, Mendrisio, Switzerland

    Guido Garavaglia

  3. Ars Medica Clinic Gravesano, Lugano, Switzerland

    Henri Ufenast

  4. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy

    Luca Maria Sconfienza

Authors
  1. Ettore Taverna
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  2. Guido Garavaglia
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Correspondence to Vincenzo Guarrella.

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Ettore Taverna has recieved consulting fees from Smith & Nephew inc. The other Authors declare that they have no conflict of interests.

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All procedures involved in this study were in accordance with the ethical standards of the institutional and national research commitee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Taverna, E., Garavaglia, G., Perfetti, C. et al. An arthroscopic bone block procedure is effective in restoring stability, allowing return to sports in cases of glenohumeral instability with glenoid bone deficiency. Knee Surg Sports Traumatol Arthrosc 26, 3780–3787 (2018). https://doi.org/10.1007/s00167-018-4921-7

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