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      Arthroscopic Xenograft With Cerclage Fixation: A Method for Glenoid Bone Loss Reconstruction With Cerclage Fixation Using a Specific Posterior Guide

      brief-report
      Author(s): , M.D. a , b , ∗ , , M.D. a , b
      Publication date (Electronic):
      Journal: Arthroscopy Techniques
      Publisher: Elsevier

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          Abstract

          Large glenoid bone defects are closely associated with high failure rates after arthroscopic Bankart repair in chronic anterior shoulder instability; therefore nowadays the glenoid bone grafting reconstruction procedure is strictly recommended. On the contrary, the optimal grafting procedure is still controversial because there is considerable concern about the resorption rate of allografts, donor site morbidity of the autografts, and sequelae caused by the use of metal fixation devices in proximity of the shoulder joint. We describe an all-arthroscopic technique for anatomic reconstruction of the glenoid that uses a previously shaped xenograft assembled with a metal-free fixation device using 2 ultra-high-strength sutures (FiberTape Cerclage System; Arthrex, Naples, FL), using a specific posterior guide (Arthrex, Naples, FL) in combination with upper third subscapularis augmentation.

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          Arthroscopic xenograft with cerclage fixation: A method for glenoid bone loss reconstruction using a specific posterior guide.

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          Most cited references37

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          Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.

          Benjamín J. Gómez-Moliner, Filip De Fruyt, Christoph S Burkhart (2000)
          Our goal was to analyze the results of 194 consecutive arthroscopic Bankart repairs (performed by 2 surgeons with an identical suture anchor technique) in order to identify specific factors related to recurrence of instability. Case series. We analyzed 194 consecutive arthroscopic Bankart repairs by suture anchor technique performed for traumatic anterior-inferior instability. The average follow-up was 27 months (range, 14 to 79 months). There were 101 contact athletes (96 South African rugby players and 5 American football players). We identified significant bone defects on either the humerus or the glenoid as (1) "inverted-pear" glenoid, in which the normally pear-shaped glenoid had lost enough anterior-inferior bone to assume the shape of an inverted pear; or (2) "engaging" Hill-Sachs lesion of the humerus, in which the orientation of the Hill-Sachs lesion was such that it engaged the anterior glenoid with the shoulder in abduction and external rotation. There were 21 recurrent dislocations and subluxations (14 dislocations, 7 subluxations). Of those 21 shoulders with recurrent instability, 14 had significant bone defects (3 engaging Hill-Sachs and 11 inverted-pear Bankart lesions). For the group of patients without significant bone defects (173 shoulders), there were 7 recurrences (4% recurrence rate). For the group with significant bone defects (21 patients), there were 14 recurrences (67% recurrence rate). For contact athletes without significant bone defects, there was a 6.5% recurrence rate, whereas for contact athletes with significant bone defects, there was an 89% recurrence rate. (1) Arthroscopic Bankart repairs give results equal to open Bankart repairs if there are no significant structural bone deficits (engaging Hill-Sachs or inverted-pear Bankart lesions). (2) Patients with significant bone deficits as defined in this study are not candidates for arthroscopic Bankart repair. (3) Contact athletes without structural bone deficits may be treated by arthroscopic Bankart repair. However, contact athletes with bone deficiency require open surgery aimed at their specific anatomic deficiencies. (4) For patients with significant glenoid bone loss, the surgeon should consider reconstruction by means of the Latarjet procedure, using a large coracoid bone graft.
          Article 0 comments Cited 148 times – based on 0 reviews     Review now
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            Short-term Complications of the Arthroscopic Latarjet Procedure: A North American Experience.

            Robert J. Meislin, George S. Athwal, Paul J Favorito … (2016)
            To report on the intraoperative and early postoperative (<3 months) problems and complications encountered with the arthroscopic Latarjet procedure in patients with complex anterior shoulder instability.
            Article 0 comments Cited 39 times – based on 0 reviews     Review now
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              A systematic review and meta-analysis of long-term studies (five or more years) assessing maxillary sinus floor augmentation.

              T Starch-Jensen, H Aludden, M Hallman … (2017)
              The objective was to test the hypothesis of no difference in long-term (≥5 years) implant treatment outcomes after maxillary sinus floor augmentation (MSFA) with autogenous bone graft compared to a mixture of autogenous bone graft and bone substitutes or bone substitutes alone. A MEDLINE (PubMed), Embase, and Cochrane Library search in combination with a hand-search of relevant journals was conducted. Human studies published in English between January 1, 1990 and October 1, 2016 were included. Nine studies fulfilled the inclusion criteria. The survival of suprastructures has never been compared within the same study. The 5-year implant survival after MSFA with autogenous bone graft was 97%, compared to 95% for Bio-Oss; the reduction in vertical height of the augmented sinus was equivalent with the two treatment modalities. Non-comparative studies demonstrated high survival rates for suprastructures and implants regardless of the grafting material used. Meta-analysis revealed an overall estimated patient-based implant survival of 95% (confidence interval 0.92-0.96). High implant stability quotient values, high patient satisfaction, and limited peri-implant marginal bone loss were revealed in non-comparative studies. No long-term randomized controlled trial comparing the different treatment modalities was identified. Hence, the conclusions drawn from the results of this systematic review should be interpreted with caution.
              Article 0 comments Cited 37 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Marco Maiotti
                Journal
                Journal ID (nlm-ta): Arthrosc Tech
                Journal ID (iso-abbrev): Arthrosc Tech
                Title: Arthroscopy Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2212-6287
                Publication date PMC-release: 04 September 2023
                Publication date Collection: October 2023
                Publication date (Electronic): 04 September 2023
                Volume: 12
                Issue: 10
                Pages: e1657-e1664
                Affiliations
                [a ]Villa Stuart Hospital, Rome, Italy
                [b ]Mediterranea Hospital, Naples, Italy
                Author notes
                [∗ ]Address correspondence to Marco Maiotti, M.D., Villa Stuart Hospital, Via Trionfale 5952, Rome 00135, Italy. maiotti.marco@ 123456gmail.com
                Article
                Publisher Item ID: S2212-6287(23)00157-3
                DOI: 10.1016/j.eats.2023.05.011
                PMC ID: 10627986
                SO-VID: e4004c61-f301-45e4-9a1d-5797e0fd4a36
                Copyright © © 2023 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 17 March 2023
                Date accepted : 27 May 2023
                Categories
                Subject: Technical Note

                Data availability:

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