Bone defect–induced alteration in glenoid articular surface geometry and restoration with coracoid transfer procedures: a cadaveric study

2019 ◽  
Vol 28 (12) ◽  
pp. 2418-2426
Author(s):  
Deepak N. Bhatia ◽  
Vikram Kandhari
2006 ◽  
Vol 88 (12) ◽  
pp. 2704-2713 ◽  
Author(s):  
Yuki Tochigi ◽  
M. James Rudert ◽  
Charles L. Saltzman ◽  
Annunziato Amendola ◽  
Thomas D. Brown

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Aditya Prinja ◽  
Antony Raymond ◽  
Mahesh Pimple

Traumatic anterior instability of the shoulder is commonly treated with the Latarjet procedure, which involves transfer of the coracoid process with a conjoint tendon to the anterior aspect of the glenoid. The two most common techniques of the Latarjet are the classical and congruent arc techniques. The aim of this study was to evaluate the difference in force required to dislocate the shoulder after classical and congruent arc Latarjet procedures were performed. Fourteen cadaveric shoulders were dissected and osteotomised to produce a bony Bankart lesion of 25% of the articular surface leading to an “inverted pear-shaped” glenoid. An anteroinferior force was applied whilst the arm was in abduction and external rotation using a pulley system. The force needed to dislocate was noted, and then the shoulders underwent coracoid transfer with the classical and congruent arc techniques. The average force required to dislocate the shoulder after osteotomy was 123.57 N. After classical Latarjet, the average force required was 325.71 N, compared with 327.14 N after the congruent arc technique. This was not statistically significant. In this biomechanical cadaveric study, there is no difference in the force required to dislocate a shoulder after classical and congruent arc techniques of Latarjet, suggesting that both methods are equally effective at preventing anterior dislocation in the position of abduction and external rotation.


2016 ◽  
Vol 45 (2) ◽  
pp. 403-409 ◽  
Author(s):  
Derek T. Bernstein ◽  
Craig A. O’Neill ◽  
Ryan S. Kim ◽  
Hugh L. Jones ◽  
Philip C. Noble ◽  
...  

Background: Conventional osteochondral allograft (OCA) matching, requiring orthotopic, size-matched condyles, and narrow surgical time windows often prohibit timely transplantation. Hypothesis: The femoral condyle radius of curvature (RoC) is an appropriate, isolated criterion for donor-host matching in fresh OCAs, potentially enhancing matching efficiency when compared with conventional matching techniques. Study Design: Descriptive laboratory study. Methods: In part 1 of this study, 3-dimensional digital reconstructions of 14 randomly selected, cadaveric distal femoral hemicondyles were performed. Each condyle was divided into anterior, middle, and posterior zones. A virtual best-fit grid was applied to each, and each zone’s sagittal- and coronal-plane RoCs were determined. Seven nonorthotopic OCA transplantations were performed based on RoC matching with 1-mm tolerance, and the preoperative and postoperative surface geometry were quantified to assess the accuracy of articular surface restoration. Of note, each donor-host pair did not match by the conventional method. In part 2 of this study, 12 cadaveric distal femora were categorized by size and digitized in the aforementioned manner. Simulated circular defects measuring 20, 25, and 30 mm in diameter were introduced into each zone. OCA matches were determined based on donor and host RoCs, and the total number of potential matches (of 71 total comparisons) was recorded as a percentage for each simulated defect. Finally, the results of RoC matching were compared with the conventional method for simulated defects in all zones of both the medial and lateral femoral condyles. Results: Part 1: The mean surface deviation after OCA transplantation was −0.09 mm, with a mean maximum protrusion at any point of 0.59 mm. Part 2: Using the RoC, 20-mm defects had a 100% chance of being matched. Defects of 25 and 30 mm had a 91% and 64% chance of being matched, respectively. Compared with the conventional method, the RoC method yielded a 3.2-fold greater match rate for lesions of the medial and lateral femoral condyles ( P = .02). Conclusion: This investigation shows that femoral condyle RoCs in the sagittal and coronal planes may be useful, alternative matching criteria, expanding on current standards. Clinical Relevance: These matching criteria may increase the number of available matches, reduce wait times for patients, and reduce the number of wasted grafts.


Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 145-149
Author(s):  
O. M. Flannery ◽  
L. C. Murphy ◽  
P. Dockery ◽  
M. E. O'Sullivan

The aim of this study was to determine the path of screw placement to avoid breaching the articular surface of both lunate and scaphoid bones at the radiocarpal and midcarpal joints. An Acutrak screw was inserted into the right scapholunate joint of ten cadavers starting immediately distal to the tip of the radial styloid and aiming for the tip of the ulnar styloid. The articular surfaces of the scaphoid and lunate bones in all ten cadavers were exposed and examined. A computed tomography (CT) scan of four wrists was performed. Eight of the ten cadavers had no perforation or destruction of the articular surfaces. Screw stabilization of the scapholunate joint can be performed without perforation or destruction of the lunate or scaphoid surfaces. We recommend that if this form of fixation is being used then the screw should be inserted commencing at the radial styloid tip and aiming for ulnar styloid tip, under radiological guidance.


Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 33-39
Author(s):  
Jessica G. Shih ◽  
James G. Mainprize ◽  
Paul A. Binhammer

Background: Given the predilection of first carpometacarpal (CMC) joint osteoarthritis in women compared with men, we aim to determine the differences in first CMC joint surface geometry and congruence between young healthy males and females. Methods: Wrist computed tomographic scan data of 11 men and 11 women aged 20 to 35 years were imported into 3-dimensional software programs. The first metacarpal and the trapezium were aligned in a standardized position according to landmarks at key points on Gaussian and maximum curvature maps. Measurements of joint congruence and surface geometry were analyzed, including joint space volume, distance between the bones at the articular surface edges, area of the joint space, and radii of curvature in the radial-ulnar and volar-dorsal planes. Results: The mean thumb CMC articular space volume was 104.02 ± 30.96 mm3 for females and 138.63 ± 50.36 mm3 for males. The mean first metacarpal articular surface area was 144.9 ± 10.9 mm2 for females and 175.4 ± 25.3 mm2 for males. After normalizing for size, the mean thumb CMC articular space volume was 119.4 ± 24.6 mm3 for females and 117.86 ± 28.5 mm3 for males. There was also no significant difference for the articular space volume, articular surface distances, articular space, and mean radii of curvatures. Conclusions: This study found that there are sex differences in the first CMC joint articular volume without normalizing for size; however, there are no sex differences in first CMC joint articular volume, curvature characteristics, or joint congruence of young, healthy patients after normalizing for joint size.


2013 ◽  
Vol 46 (3) ◽  
pp. 364-369 ◽  
Author(s):  
S. E. Halley ◽  
M. J. Bey ◽  
J. A. Haladik ◽  
M. Lavagnino ◽  
S. P. Arnoczky

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