2019 ISAKOS Biennial Congress ePoster #1805
Preliminary Results of the Use of Osteochondral Transplantation in the Proximal Humeral Surgical Procedures
Rodrigo S. Borges Petros, MD, Rio De Janeiro, RJ BRAZIL
Rafael A. Dantas-Prinz, Rio de Janeiro, RJ BRAZIL
Alex Sandro M. Da Silva, MD, Rio de Janeiro, RJ BRAZIL
Paula Emilia V. Ferreira, MD, Rio de Janeiro, RJ BRAZIL
Rafael S. B. Petros, Rio de Janeiro, RJ BRAZIL
Hospital de Traumatologia e Ortopedia (HTO) Dona Lindu, Rio de Janeiro , RJ, BRAZIL
FDA Status Not Applicable
The use of fresh osteochondral transplantation of the proximal humerus for patients younger than 40 years with large osteochondral defects appears to be an alternative treatment for those patients who are difficult to conduct because of the few available treatment options.
The purpose of the article was To describe the technique and present the preliminary results of the use of osteochondral transplantation of the entire articular surface of the proximal humerus in the treatment of large joint defects in young patients.
Ten patients with a humeral head defect involving more than 40% of the joint surface, due to two specific pathologies, osteonecrosis and chronic blocked posterior dislocation were submitted to surgical treatment. The defect in the head was filled with allogeneic osteochondral graft, preserved in specific medium to maintain viability of chondrocytes, and transplanted within 3 weeks after removal. Radiographs and computed tomography were performed at the follow-up to evaluate graft incorporation. The clinical evaluation was performed through the SF-36 quality of life score and the functional score by the American Shoulder and Elbow Surgeons score and Costant Score.
The mean age of the patients was 31 years (21-41), with a mean follow-up of 14 months (12-27) in this initial analysis. In the tomographic evaluation, 8 grafts presented complete incorporation. Significant clinical improvement, as demonstrated by the analogue pain scale (VAS) from 7.1 to 1.7, the American Shoulder and Elbow Surgeons Scale ranged from 37 to 75, and Costant Score from 41 in the preoperative period to 76 in 12 months postoperative period. Eight patients are satisfied with the result obtained. Development of arthrosis occurred in one case and partial graft resorption were not found in the radiographic evaluations in this preliminary analysis.
The clinical results obtained in these young patients seem to support the applicability of fresh osteochondral allograft implantation in the shoulder, in cases of ostracosis and blocked posterior dislocation.
The development of arthritis of the implanted surfaces is a cause of concern for long-term follow-up.