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European Journal of Orthopaedic Surgery & Traumatology

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01-12-2020 | Computed Tomography | Original Article

Is there a difference in outcome of arthroscopic iliac crest autograft and allograft in recurrent anterior shoulder instability?

Authors: Shahbaz S. Malik, Saad Elashry, Robert W. Jordan, Surabhi Choudhary, Socrates Kalogrianitis

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 8/2020

Abstract

Objective

The aim of this study was to compare outcomes of arthroscopic tricortical iliac crest autograft and allograft bone blocks for recurrent traumatic anterior shoulder instability in terms of bone resorption, union and recurrent instability and assess which one is a better graft choice.

Patients and methods

Twenty-two consecutive patients treated for recurrent traumatic anterior shoulder instability that required reconstruction with bone block were included in the study. Surgical reconstruction was carried out arthroscopically with contoured tricortical iliac crest autograft or allograft. At follow-up, patients were assessed for Oxford Shoulder Instability Score (OSIS), recurrent dislocation, apprehension testing, complications, and 3-dimensional computed tomography (CT) for resorption and union rate at a mean of 10.89 months.

Results

There were 10 patients in the allograft group with a median age of 27.7 years and a mean follow-up of 26.6 months. In the autograft group, there were 12 patients with a median age of 29 years and a mean follow-up of 28.7 months. The OSIS increased in both groups but was significantly higher in the autograft group (54.1 vs 48.2, p = 0.02). There were 2 failures in each group but no hardware complications. Allograft had higher resorption rate in comparison (75% in allograft vs 40% in autograft) and higher non-union rate (62.5% in allograft vs 16.5% in autograft).

Conclusion

This study demonstrated that both tricortical iliac crest autograft and allograft can improve shoulder instability symptoms. However, the results suggest that autograft may lead to significantly improved instability score, higher union rate and less bone resorption.

Level of evidence

IV, retrospective study.

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Title: Is there a difference in outcome of arthroscopic iliac crest autograft and allograft in recurrent anterior shoulder instability?
Authors: Shahbaz S. Malik
Saad Elashry
Robert W. Jordan
Surabhi Choudhary
Socrates Kalogrianitis
Publication date: 01-12-2020
Publisher: Springer Paris
Keywords: Computed Tomography
Shoulder Instability
Computed Tomography
Iliac Crest Graft
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 8/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02722-2

At a glance: The STEP trials

Springer Medicine

Is there a difference in outcome of arthroscopic iliac crest autograft and allograft in recurrent anterior shoulder instability?

Abstract

Objective

Patients and methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Patients and methods

Results

Conclusion

Level of evidence

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