John M. Tokish, M. D. , Kelly Fitzpatrick, D. O. , Jay B. Cook, M. D

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Presentation transcript:

Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss John M. Tokish, M.D., Kelly Fitzpatrick, D.O., Jay B. Cook, M.D., William J. Mallon, M.D. Arthroscopy Techniques Volume 3, Issue 4, Pages e475-e481 (August 2014) DOI: 10.1016/j.eats.2014.05.006 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 The distal clavicle graft matches the contour and can restore the articular arc of a glenoid with significant bone loss. Arthroscopy Techniques 2014 3, e475-e481DOI: (10.1016/j.eats.2014.05.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 Three-dimensional reconstructed computed tomography scan showing significant glenoid bone loss in a patient treated with posterior augmentation with distal clavicular autograft. Arthroscopy Techniques 2014 3, e475-e481DOI: (10.1016/j.eats.2014.05.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 Postoperative radiograph showing defect left after harvesting of distal clavicular autograft. This patient had no donor-site pain after 6 weeks. Arthroscopy Techniques 2014 3, e475-e481DOI: (10.1016/j.eats.2014.05.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 The distal clavicle is compared with the coracoid in the same cadaveric specimen, showing comparable size between the 2 graft choices. Arthroscopy Techniques 2014 3, e475-e481DOI: (10.1016/j.eats.2014.05.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 Graft preparation for suture anchor fixation. The single stitches will be tied together over a bone bridge, and the other 2 ends will be retracted to reduce the graft in a double-pulley construct. Arthroscopy Techniques 2014 3, e475-e481DOI: (10.1016/j.eats.2014.05.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic graft passage of distal clavicular autograft for posterior bone loss. (C, clavicle graft; G, glenoid.) Arthroscopy Techniques 2014 3, e475-e481DOI: (10.1016/j.eats.2014.05.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 7 Fixation of distal clavicular autograft in a patient with posterior glenoid bone loss. (C, clavicle graft; G, glenoid.) Arthroscopy Techniques 2014 3, e475-e481DOI: (10.1016/j.eats.2014.05.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions