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Distal Clavicular Osteochondral Autograft Augmentation for Glenoid Bone Loss: A Comparison of Radius of Restoration Versus Latarjet Graft

      Introduction

      The purpose of this paper is to evaluate a distal clavicular autograft for suitability for augmentation of glenoid bone loss in the setting of glenohumeral instability. Specifically, we sought to compare the radius of reconstruction of this graft with that of an ipsilateral coracoid graft as prepared for a Latarjet procedure. Further, we sought to compare the articular cartilage thickness of the distal clavicle graft with that of the native glenoid.

      Methods

      Twenty-seven fresh frozen cadaver specimens were dissected and an open distal clavicle excision was performed. In addition, the coracoid process in each specimen was prepared as is described for a Latarjet coracoid transfer. In each specimen, the distal clavicle graft was compared to the coracoid graft for size and potential of glenoid articular radius of restoration. The distal clavicle graft was also compared to the native glenoid for cartilage thickness.

      Results

      In all specimens, the distal clavicle grafts provided a greater radius of glenoid restoration than the coracoid grafts, p =0.00000008. On average the clavicular graft restored 44% of glenoid diameter, compared to 33% in the case of the coracoid graft p=0.00000009. Glenoid cartilage averaged 1.44 mm thicker in the native glenoid compared to the distal clavicular autograft, p=0.000008. When specimens with OA were excluded this difference decreased to 0.97 when compared to the clavicular cartilage (p=0.0026).

      Conclusion

      The distal clavicle autograft can restore a glenoid bone deficit of a greater radius than a coracoid as prepared for a Latarjet procedure, and provides a source of articular cartilage to the reconstruction. The articular cartilage thickness is within 1.5 mm of that of the native glenoid.