Structural auto- and allograft glenoid bone grafting in reverse shoulder arthroplasty - Retrospective radiological analysis of 38 cases

Kaisa Lehtimäki , Milja Holstila , Keijo Mäkelä , Juha Kukkonen , Kari Tirkkonen , Jenni Harjula , Tommi Kauko , Ville Äärimaa
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Abstract

Background

A structural glenoid bone graft may be utilized in conjuction with reverse shoulder arthroplasty (RSA) in order to address native bone deficiency and/or lateralize the glenoid. The longevity of this type of construct is of potential concern especially with allograft bone grafting. We wanted to study the radiographic construct survival in primary and revision RSA with structural glenoid auto- and allograft bone grafting.

Methods

We retrospectively identified all patients who had undergone RSA, with an encompassing structural bone graft under the metaglene bearing at Turku University Hospital between 2014 and 2019. All patients were called for follow-up and evaluated radiographically and clinically. Shoulders were divided into auto- and allograft groups and radiographic bone graft incorporation and component survival were used as primary outcome measures and between group differences were statistically analyzed.

Results

There were 38 shoulders/34 patients (out of 56) with a mean follow-up of 34 months. The mean age of patients at time of surgery was 69 years (SD 11). 26 auto- and 12 allografts were used at index surgery. At follow-up the bone graft was fully incorporated, partially incorporated and fully resorbed in 44 %, 50 % and 6 % of cases respectively. There was no statistically significant difference in bone graft incorporation between the groups and none of the prosthesis components showed radiographic signs of loosening.

Conclusions

Glenoid bone grafting in conjunction with RSA is a safe and reliable method to restore the glenoid bone stock and secure the construct in short term follow-up. There may be no significant difference in component survival between auto- and allograft bone grafting techniques. Longer-term follow-up is needed to assess the final outcome with regard to these techniques.

Level of evidence

Level IV; Case series, Treatment Study.
反向肩关节置换术中的结构自体和同种异体盂骨移植 - 38 例病例的回顾性放射学分析
背景结构性盂骨移植可与反向肩关节置换术(RSA)结合使用,以解决原生骨缺失和/或使盂侧化。这种结构的寿命是一个潜在的问题,尤其是异体骨移植。我们希望研究使用结构性盂体自体骨和同种异体骨移植的初次和翻修RSA的影像学结构存活率。方法我们回顾性地确定了2014年至2019年期间在图尔库大学医院接受RSA手术的所有患者,这些患者都在metaglene支座下进行了结构性骨移植。我们召集了所有患者进行随访,并对其进行了放射学和临床评估。肩部被分为自体组和异体组,并将放射学植骨结合率和组件存活率作为主要结果测量指标,对组间差异进行统计学分析。结果56名患者中有38名肩部患者/34名患者,平均随访34个月。手术时患者的平均年龄为 69 岁(标准差 11 岁)。指标手术中使用了 26 块自体骨和 12 块异体骨。在随访中,分别有 44%、50% 和 6% 的病例的植骨完全融合、部分融合和完全吸收。结论蝶骨移植与 RSA 联合使用是一种安全可靠的方法,可在短期随访中恢复蝶骨骨量并固定假体结构。自体骨移植和同种异体骨移植技术在组件存活率方面可能没有明显差异。需要更长期的随访来评估这些技术的最终结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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