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Glenoid Tricortical Iliac Crest Structural Bone Graft Enhanced With Resorbable Cement for the Treatment ofAseptic Glenoid Loosening

Young, Allan A. MD, MBBS, MSpMed, PhD, FRACS (Orth)*; Neyton, Lionel MD; Molony, Diarmuid C. MD*; Boileau, Pascal MD; Walch, Gilles MD

Techniques in Shoulder & Elbow Surgery:
doi: 10.1097/BTE.0b013e31820b3517
Techniques
Abstract

Aseptic glenoid loosening is the most frequent cause of revision and can be associated with severe cavitary, segmental, or combined glenoid bone defects. In this study, we describe a glenoid reconstruction technique using tricortical iliac crest graft supplemented with resorbable bone cement. We report on the results of this technique in 6 patients with an average follow-up of 15 months. The average Constant score improved from 36.8 to 59.8 points after revision. Subjectively, 5 of the 6 patients were satisfied with their results and 1 patient was disappointed. We observed satisfactory healing of the graft and maintained homogenous density of the graft in 5 of 6 cases. There was severe erosion of the graft in the case with poor healing and graft resorption, possibly due to a low-grade infection, although this was not proven. There was a partial erosion of the graft observed in 2 additional cases, whereas the remaining 3 cases had no, or only minimal, erosion. Although long-term follow-up is necessary, we have been pleased with the early results of this technique for glenoid reconstruction in the presence of severe glenoid bone loss, an extremely difficult and challenging surgical problem.

Level of Evidence: Case series IV.

Author Information

*Sydney Shoulder Specialists, Sydney, Australia

Centre Orthopédique Santy and Hopital Privé Jean Mermoz, Avenue Paul Santy, Lyon

Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet II, Medical University of Nice-Sophia Antipolis, Nice, France

Supported by none.

The Institutional Review Board of the ethical committee of the Hopital Privé Jean Mermoz and the Centre Orthopédique Santy approved this study (Ref. Study 23).

Disclaimer/s: None.

Reprints: Allan A. Young, MD, Sydney Shoulder Specialists, Suite 201, Level 2, 156 Pacific Highway, St Leonards 2065, Sydney, Australia (e-mail: youngadmin@sydneyshoulder.com.au).

Received October 14, 2010

Accepted November 30, 2010

© 2011 Lippincott Williams & Wilkins, Inc.