Biomechanical Evaluation and Surface Analysis of Glenoid Reconstruction Using a Subtalar Joint Allograft for Significant Glenoid Bone Loss in Recurrent Shoulder Instability: A Novel Alternative Graft Option.

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Tác giả: Marco Adriani, Wyatt H Buchalter, Amelia H Drumm, Phob Ganokroj, Alexander R Garcia, Justin F M Hollenbeck, Trevor J McBride, Matthew T Provencher, Marco-Christopher Rupp, Ryan J Whalen

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: United States : The American journal of sports medicine , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 710198

BACKGROUND: Glenoid and humeral head bone defects are common in chronic shoulder instability. The talus, and more specifically, the subtalar joint, has been proposed as a unique allograft from which bipolar bone loss can be addressed. However, there are few biomechanical data or joint reconstruction analyses of the glenoid using the posterior facet of a subtalar joint allograft (STA). PURPOSE: To compare the contact mechanics of an STA versus a coracoid graft (Latarjet procedure) versus a distal tibial allograft (DTA) for anatomic glenoid reconstruction. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 8 fresh-frozen, unpaired cadaveric specimens underwent repeated-measures biomechanical testing in 5 stages: native (intact) state, bone loss (30% glenoid bone defect), Latarjet procedure, glenoid reconstruction using a DTA, and glenoid reconstruction using an STA. A compressive load of 440 N was applied to the glenohumeral joint when the humerus was mounted to a dynamic tensile testing machine in 3 shoulder positions: 30° of abduction, 60° of abduction, and 60° of abduction with 90° of external rotation (ER). Average contact pressure, contact area, and peak contact pressure were determined from the sensors. Surface area and surface congruency were calculated using a custom script. Data were analyzed using analysis of variance. RESULTS: There was a significantly higher surface area with glenoid reconstruction using the DTA (859 ± 78 mm CONCLUSION: Anatomic glenoid reconstruction using a DTA or STA restored average contact pressure, peak contact pressure, and contact area at 60° of abduction and 60° of abduction with 90° of ER in a cadaveric model. In addition, surface congruency and surface area improved over the traditional Latarjet procedure. CLINICAL RELEVANCE: The STA showed comparable contact mechanics and surface geometry to the DTA. Further research is needed to determine the in vivo clinical outcomes of this new alternative graft.
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