Article ; Online: Biomechanical Analysis of Posterior Open-Wedge Osteotomy and Glenoid Concavity Reconstruction Using an Implant-Free, J-Shaped Iliac Crest Bone Graft.
The American journal of sports medicine
2022 Volume 50, Issue 14, Page(s) 3889–3896
Abstract: Background: Posterior open-wedge osteotomy and glenoid reconstruction using a J-shaped iliac crest ... performance of the posterior J-shaped graft to restore glenoid retroversion and posteroinferior deficiency ... glenoid deficiency, and (4) posterior J-shaped graft (at 0° of retroversion). With the humerus in the Jerk ...
| Abstract | Background: Posterior open-wedge osteotomy and glenoid reconstruction using a J-shaped iliac crest bone graft showed promising clinical results for the treatment of posterior instability with excessive glenoid retroversion and posteroinferior glenoid deficiency. Purpose: To evaluate the biomechanical performance of the posterior J-shaped graft to restore glenoid retroversion and posteroinferior deficiency in a cadaveric shoulder instability model. Study design: Controlled laboratory study. Methods: A posterior glenoid open-wedge osteotomy was performed in 6 fresh-frozen shoulders, allowing the glenoid retroversion to be set at 0°, 10°, and 20°. At each of these 3 preset angles of glenoid retroversion, the following conditions were simulated: (1) intact joint, (2) posterior Bankart lesion, (3) 20% posteroinferior glenoid deficiency, and (4) posterior J-shaped graft (at 0° of retroversion). With the humerus in the Jerk position (60° of glenohumeral anteflexion, 60° of internal rotation), stability was evaluated by measuring posterior humeral head (HH) translation (in mm) and peak translational force (in N) to translate the HH over 25% of the glenoid width. Glenohumeral contact patterns were measured using pressure-sensitive sensors. Fixation of the posterior J-graft was analyzed by recording graft micromovements during 3000 cycles of 5-mm anteroposterior HH translations. Results: Reconstructing the glenoid with a posterior J-graft to 0° of retroversion significantly increased stability compared with a posterior Bankart lesion and posteroinferior glenoid deficiency in all 3 preset degrees of retroversion ( Conclusion: Biomechanical analysis of the posterior J-graft demonstrated reliable restoration of initial glenohumeral joint stability, normalization of contact patterns comparable with that of an intact shoulder joint with neutral retroversion, and secure initial graft fixation in the cadaveric model. Clinical relevance: This study confirms that the posterior J-graft can restore stability and glenohumeral loading conditions comparable with those of an intact shoulder. |
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| MeSH term(s) | Humans ; Ilium/surgery ; Joint Instability/surgery ; Shoulder Joint/surgery |
| Language | English |
| Publishing date | 2022-10-28 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 197482-8 |
| ISSN | 1552-3365 ; 0363-5465 |
| ISSN (online) | 1552-3365 |
| ISSN | 0363-5465 |
| DOI | 10.1177/03635465221128918 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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