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RESEARCH & ARTICLES

A Bio Perspective on Distal Tibia Osteochondral Allograft for Reconstruction of Glenoid Bone Defects

Purpose: To illustrate the cadaveric biomechanical findings associated with the use of a distal tibia allograft (DTA) as an option for the surgical management of shoulder instability caused by large glenoid bone defects.

Summary:

  • Defects greater than 30% of the glenoid surface often require an autograft or allograft
  • Use of an iliac crest is a common technique but has disappointing long-term clinical results with high rates of patient dissatisfaction and the inability to return to previous levels of activity
  • Laboratory work has shown a nearly identical radius of curvature between the glenoid and a DTA throughout the full range of motion
  • Reconstruction of anterior glenoid with a DTA may lower peak contact forces and improve biomechanics compared with the Latarjet procedure
  • Reconstruction of the posterior glenoid with a DTA exhibited similar contact mechanics when compared to using an iliac crest autograft

Take Away: Initial research has shown that at a minimum, glenoid reconstruction with a fresh DTA offers an alternative surgical option that could restore biomechanics and biology, reduce rates of dislocation and improve pain and function for the difficult problems associated with treatment of the glenoid.

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Authors: Rachel M. Frank, MD, Sanjeev Batia, MD, Neil Ghodadra, MD,  Elizabeth Shewman, MS, Vincent M. Wang, PhD, Bernard R. Bach Jr, MD, Gregory Nicholson, MD, Brian J. Cole, MD, MBA, Matthew T. Provencher, MD, Nikhil N. Verma, MD, Anthony A. Romeo, MD

Published: Rush Orthopedics Journal

Institution: Rush University Medical Center, Chicago, Illinois