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The J-Shaped Bone Graft for Anatomic Glenoid Reconstruction: A 10-Year Clinical Follow-up and Computed
Christian Deml1,2, Peter Kaiser1, Wouter F van Leeuwen2
1Department of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Background:
The J-shaped bone graft procedure is one of the recommended methods to reconstruct significant glenoid rim defects.
Purpose:
To evaluate long-term (minimum 10-year) clinical outcomes and show further details of the remodeling effects on the articular cavity of the glenoid after J-shaped bone grafting.
Study Design:
Case series; Level of evidence, 4.
Methods:
A total of 14 patients treated with a J-shaped bone graft procedure were observed clinically. Additionally, bilateral preoperative and postoperative follow-up computed tomography (CT) scans were used for CT-osteoabsorptiometry (OAM) to evaluate the bony remodeling processes.
Results:
The follow-up rate was 93% at a mean follow-up time of 10.7 years (range, 10.08-11.75 years). Patients exhibited a mean Constant score of 92.5 (range, 80-100) on the clinical evaluation. All patients had free range of motion and were pain free without any recurrence of instability. Based on CT-OAM, comparable and almost anatomically reconstructed, bilaterally equal glenoid cavities were found postoperatively. The distribution patterns of glenoid subchondral mineralization were bilaterally equal in 85.7% of the patients.
Conclusion:
The surgical treatment of recurrent shoulder instability with a significant bony Bankart lesion using the J-shaped bone graft procedure provided excellent long-term results. This study lends evidence to support the capability of the J-shaped bone graft procedure to restore the normal glenoid shape due to physiological remodeling processes.
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