Summary

Radiological comparison of different grafts and different fixation techniques

Abstract

Purpose

to evaluate bone integration and osteolysis of glenoid grafting in the context of shouder anterior-inferior instability.

Methods

graft osteointegration and osteolysis was retrospectively evaluated with ct scan imaging performed at 12 months after surgery to compare results of Latarjet procedure, Bone block procedure with allograft and bone block procedure with xenograft. Screw fixation and double endobuttons fixation was also compared.

Results

ct scan imaging of 123 patients were analysed. Of these 23 were performed in patients who underwent Bone Block procedure with xenograft and Endobuttons fixation, 55 underwent Bone Block procedure with allograft and Endobuttons fixation, 13 Latarjet procedure with screw fixation and 32 Latarjet with Endobuttons fixation.
Osteolysis was inferior in Bone Block procedure compared to Latarjet procedure (12.8% vs 28.9%) but the result vas not statistically significant (P value 0.10).
Bone integration was higher in Bone Block procedure than Latarjet procedure but the result was not statistically significant (P value > 0,5).
Within the Latarjet procedures Endobuttons fixation resulted in a higher integration rate (87,5% vs 73,6%) and lower osteolysis rate compared to screw fixation (25% vs 38,4%) but the result was not statistically significant.
Within the Bone Block procedures the use of a Xenograft resulted in a higher integration rate (92%) and lower osteolysis rate (8%) compared to the use of an Allograft (16,3%) but the result was not statistically significant.

Conclusions

Glenoid bone loss is a major risk factor for recurrence in anterior-inferior shoulder instability. Therefore high rate of bone graft integration and low rate of graft osteolysis are crucial to achieve optimal results. This study shows a lower rate of graft osteolysis after Bone Block procedure compared to Latarjet procedure. Other non statistically significant findings suggest better results in terms of osteolysis and graft integration with xenograft compared to allograft and with double endobuttons fixation compared to screw fixation.