title: Arthroscopic anatomic glenoid reconstruction using an autologous iliac crest bone grafting technique.
abstract: BACKGROUND
  Open bone block procedures for glenohumeral stabilization have been used for a long time. With the advancement of arthroscopic techniques and the development of sophisticated instruments and implants, the insertion of the bone block can be performed by an all-arthroscopic approach. The purpose of this study was to evaluate the clinical and radiologic results after an arthroscopic anatomic glenoid reconstruction using an all-arthroscopic, autologous tricortical iliac crest bone grafting technique.
  
  
  METHODS
  Fifteen patients (1 female and 14 male patients; mean age, 31.4 years [range, 17-49 years]) underwent reconstruction of significant glenoid defects in cases of recurrent shoulder instability by the aforementioned technique. The patients were followed up clinically (range of motion, Constant score, Rowe score, Subjective Shoulder Value, and Western Ontario Shoulder Instability Index) and radiographically (with true anteroposterior and axillary views, as well as 2-/3-dimensional computed tomography [glenoid configuration, signs of graft resorption, bone consolidation, and glenoid index]).
  
  
  RESULTS
  After a mean follow-up period of 20.6 months (range, 12-65 months), the Constant score averaged 85.0 points (range, 73-98 points; contralateral side, 89.6 points [range, 78-96 points]), the Rowe score averaged 88.0 points (range, 65-100 points), the Subjective Shoulder Value averaged 84.5% (range, 50%-100%), and the Western Ontario Shoulder Instability Index averaged 76.7% (range, 46%-93%). No recurrent subluxations or dislocations were observed. Radiographically, computed tomography imaging showed a consolidated autograft in all cases. The glenoid index increased from a mean of 0.77 preoperatively to 1.16 immediately postoperatively; at the time of last follow-up, the glenoid index decreased to 1.04.
  
  
  CONCLUSIONS
  The arthroscopic reconstruction of anteroinferior glenoid defects re-creates the pear-shaped anatomy of the anteroinferior glenoid and leads to good to excellent early clinical results.
authors.affiliation: Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Natascha
authors.initials: N
authors.lastname: Kraus
authors.affiliation: Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Tanawat
authors.initials: T
authors.lastname: Amphansap
authors.affiliation: Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerhardt
authors.affiliation: Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany. Electronic address: markus.scheibel@charite.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Scheibel
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012540:Scapula / Q000601:surgery*; D012783:Shoulder Dislocation / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: Shoulder instability; arthroscopic stabilization; bone block procedure; glenoid defect