2017 ISAKOS Biennial Congress Paper #264

Clavicular Osteochondral Graft as a Treatment of a Glenoid Bone Deficiency, a Comparison of Glenoid Resurfacing Capability Versus Coracoid Latarjet Transfer

Adam Kwapisz, MD, PhD, Lódz POLAND
Kelly V Fitzpatrick , DO, Tacoma, WA UNITED STATES
Jay B Cook, MD, Fort Stewart, GA UNITED STATES
John M. Tokish, MD, Simpsonville, SC UNITED STATES

Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina, UNITED STATES

FDA Status Not Applicable

Summary

The clavicular osteochondral graft was able to augment 44% of glenoid radial bone loss, compared to 33% achieved from the Latarjet graft.

Abstract

Purpose

The aim of this study is to evaluate a distal clavicle osteochondral autograft as a possible option for treating glenoid bone loss in patients with instability. We compared clavicular augmentation with the Latarjet technique as a gold standard in glenoid deficiency treatment. Further, we calculated differences in articular cartilage thickness between clavicular grafts and native glenoids.

Methods

Twenty-seven fresh frozen cadaver shoulders were dissected and distal clavicle excision was performed, In addition, we performed coracoid harvesting and graft preparation according to the Latarjet technique. Articular cartilage was measured on the glenoid side by making a saw cut perpendicular to the articular surface along the long axis, and measuring the thinkness with a digital micrometer. The distal clavicular graft was similarly evaluated for cartilage thickness.

Results

The distal clavicular osteochondral autograft resulted in significantly greater glenoid radius restoration compared to a Latarjet graft, p<0.0001. The clavicular osteochondral graft was able to augment 44% of glenoid radial bone loss, compared to 33% achieved from the Latarjet graft. In all specimens articular cartilage was present at the clavicular grafts, but was 1,44 mm thinner than the native glenoids, p<0.0001.

Conclusion

Distal clavicular osteochondral graft may resurface a greater amount of glenoid radius when compared to a Latarjet coracoid graft. It’s cartilage is of similar thickness to that of the native glenoid, and may provide a reasonable option for treatment of glenoid bone loss in the setting of anterior instability.