Osteochondral allograft transplantation for treatment of glenohumeral instability.
The intimate contact between articular surfaces of the humeral head and glenoid labrum contribute to glenohumeral stability. When the articular surface area of these 2 surfaces is decreased, as with the presence of a bony Bankart lesion or an engaging Hill-Sachs lesion, the shoulder is more prone to dislocation. Although osteochondral allograft transplantation has become widely popular for the treatment of osteochondral defects of the knee, it is less used for treating bony defects of the humeral head. We present a case in which a 16-year-old male athlete with multiple anterior shoulder dislocations underwent arthroscopic repair of a Bankart lesion. His arthroscopic repair ultimately failed and on subsequent magnetic resonance imaging he was found to have a large, engaging Hill-Sachs defect. He underwent arthroscopic osteochondral allograft transplantation to correct the humeral head bony deformity. As of the 1-year follow-up, the patient has had no recurrences and had returned to his normal level of activity.
Chapovsky
Felix
F
Department of Orthopedic Surgery, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA.
Kelly
John D
JD
D000293:Adolescent; D001182:Arthroscopy / Q000379:methods*; D001490:Basketball / Q000293:injuries; D016025:Bone Transplantation; D002356:Cartilage / Q000637:transplantation*; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D003131:Combined Modality Therapy; D005596:Fractures, Closed / Q000150:complications / Q000601:surgery*; D006801:Humans; D007103:Immobilization; D007593:Joint Instability / Q000209:etiology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012783:Shoulder Dislocation / Q000150:complications; D012784:Shoulder Fractures / Q000150:complications / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D014184:Transplantation, Homologous; D016312:Treatment Refusal