Paper 02: Distal Radius Allograft for Glenohumeral Instability: A Novel Osteochondral Allograft Reconstruction Option in the Setting of Glenoid Bone Loss

Objectives: Glenoid bone loss in the setting of recurrent shoulder instability remains a challenging surgical problem. The coracoid process and iliac crest currently serve as primary autograft options for glenoid reconstruction. With regards to allograft alternatives, distal tibia, first described 2007, has good midterm outcomes when used during an index surgery cases failed prior Latarjet While tibia performs well reconstructing bony defect, it is nonanatomic reconstruction does not match radius curvature (ROC) anterior posterior (AP) plane. No work evaluated utilization dorsal articular portion option with deficiency. purpose this study was evaluate fresh frozen potential through assessment graft ROC mineral density (BMD). Distal utilized comparison group both cadaveric Computerized Tomography (CT) analysis. Methods: Eighteen fresh-frozen human specimens (6 shoulder, 6 wrist, tibia) were study. Specimens without osteoarthritis or procedures included. CT scans obtained all confirm absence osteoarthritis, significant joint deformity, evidence procedure. dissected free soft tissues except labrum wrist ligaments radius. each specimen independently measured by two fellowship trained surgeons superior inferior (SI) AP planes. Graft length SI plane also assessed. A thirty percent defect then created grafts harvested assess fit post-fixation [Figure 1]. CTs analyzed BMD specimen. Results: On analysis, mean 39.7 mm compared 36.8 30.0 [Table 1A]. Average 29.0 +/- 5.3 glenoid, 37.8 4.9 24.0 3.7 tibia; plan average 39.6 6.6 30.4 18.6 126.3 9.5 1B]. 1.5 30.3 5.6 24.5 9.4 30.8 2.0 19.1 2.3 46.7 21.7 2A]. Mean 226.3 79.0 228.5 +/-94.7 radius, 235.0 96.2 process, 235.1 84.6 2B]. Conclusions: Given supply cost constraints, exploration additional necessitated. This presents novel patients glenohumeral instability. Compared allograft, had greater providing possible larger defects. more acute (closer that glenoid) buttress humeral translation. Furthermore, employ radio-carpal perform capsular repair following fixation. Finally, (coracoid tibia), significantly diminished on loss; further biomechanical clinical investigation indicated. [Table: see text][Table: text]