[Translated article] Arthroscopic bone block metal-free fixation for anterior shoulder instability. Short-term functional and radiological outcomes

Abstract

Introduction: Anterior glenohumeral bone loss reconstruction reduces failure rates after soft tissue surgery in patients with large glenoid bone defects. Multiple bone block techniques have been described, most with metal hardware fixation. The objective of this study is to evaluate the safety, as well as the short term functional and radiological results of an arthroscopic bone block metal-free fixation or Bone Block Cerclage (BBC). Materials and methods: Retrospective study of patients with glenohumeral instability and >15% glenoid bone loss operated during 2019 with follow-up (FU) of at least 12 months. Radiography and computed tomography (CT) studies were performed. Functional outcomes were evaluated before and after surgery with the Western Ontario Shoulder Instability Index (WOSI) and Rowe score. Results: A total of 21 patients with a median age of 30.6 (SD-7.1) were included. All showed radiographic consolidation at 3 months FU. 90.4% of bone grafts presented osteolysis at peripherical areas and 95.2% revealed consolidation in the areas with contact to the glenoid. The median glenoid estimated surface went from 79.3% before surgery to 98.4% at 12 months. Functional scores were statistically significant (p 15% con 12 meses de seguimiento mínimo. Se sometieron a estudio radiográfico y tomografía axial computarizada (TAC). Se cumplimentaron escalas funcionales de manera pre y postoperatoria: Western Ontario Shoulder Instability Index (WOSI) y la escala de Rowe. Resultados: Se incluyeron un total de 21 pacientes con edad media de 30,6 (DE: 7,1). Todos mostraron consolidación radiográfica a los 3 meses. El 90,4% de los injertos presentó osteólisis en las áreas más periféricas y el 95,2% presentó consolidación en las áreas de contacto con la glenoides. La media del área de superficie de la glenoides pasó de 79,3% preoperatorio al 98,4% a 12 meses. Los resultados funcionales medios resultaron estadísticamente significativos (p < 0,001), tanto para el índice WOSI (de 35,6 a 86,9) como para la escala de Rowe (de 25,2 a 96,4). No se presentaron complicaciones graves. Conclusión: La técnica BBC es una técnica de fijación segura, sin componentes metálicos. Consigue una consolidación completa del injerto con buenos resultados funcionales y radiográficos a los 12 meses.

Keywords

• Hombro
• Inestabilidad
• Anterior
• Defecto óseo
• bloque óseo
• Tope óseo