AUVA Trauma Centre Vienna Meidling, Kundratstraße 37, A-1120, Vienna, Austria.
Sigmund Freud University, Freudplatz 1, A-1020, Vienna, Austria.
Arch Orthop Trauma Surg. 2022 Jun;142(6):1047-1054. doi: 10.1007/s00402-021-03777-4. Epub 2021 Jan 24.
With the help of a J-shaped bicortical iliac crest bone graft, the morphology of the glenoid can be augmented without having to use screws to achieve glenohumeral stability. The aim of this retrospective clinical study was to evaluate the clinical stability and function of the shoulder joint as well as the radiological remodelling process and arthropathic outcomes following the J-bone graft technique.
34 patients with recurrent shoulder dislocations and bony glenoid defects were treated with the J-bone graft technique between 2010 and 2018 at our level-I trauma centre. 15 patients (18 shoulders) could be recruited for the study. Pain levels, ASES, UCLA, SST, DASH, Rowe and WOSI Scores were collected using questionnaires. In 13 patients (16 shoulders) the Constant Score, ROM, CT with 3D reconstruction of the glenoid to assess the graft remodelling and X-rays were performed additionally.
None of the patients suffered subluxations or recurrent dislocations during the follow-up period. The overall complication rate was 11%. The evaluation using objective and subjective shoulder function scores yielded good-to-excellent results. Radiological assessment at follow-up showed a low rate of moderate-to-severe arthritis (12%) and a high rate of shoulders without any signs of arthritic degeneration (53%). The CT scans all revealed an almost complete restoration of the glenoid with none of the grafts being resorbed. A rise in the average glenoid circumference and glenoid area could be demonstrated between preoperative measurements (81.6 and 82.4%, respectively) and follow-up measurements (104 and 102.5%, respectively).
The results of this study show a successful stabilisation of the shoulder joint and a low complication rate following the J-bone graft technique. Remodelling of the bone graft could be demonstrated, which in turn led to an almost perfect glenoid surface area of 100%.
借助 J 形双皮质髂嵴骨移植物，可以在不使用螺钉来实现盂肱关节稳定性的情况下，增加关节盂的形态。本回顾性临床研究的目的是评估 J 型骨移植技术后盂肱关节的临床稳定性和功能，以及关节的重塑过程和关节病结果。
2010 年至 2018 年，在我们的 I 级创伤中心，对 34 例复发性肩关节脱位和骨肩胛盂缺损患者采用 J 型骨移植技术治疗。研究共纳入 15 例患者（18 侧肩）。通过问卷调查收集疼痛水平、ASES、UCLA、SST、DASH、Rowe 和 WOSI 评分。在 13 例患者（16 侧肩）中，还进行了 Constant 评分、ROM、CT 三维重建评估移植物重塑和 X 线检查。
在随访期间，无患者出现半脱位或复发性脱位。总的并发症发生率为 11%。客观和主观肩关节功能评分评估结果为优至良。影像学评估显示，中度至重度关节炎发生率低（12%），无关节炎退变迹象的发生率高（53%）。CT 扫描均显示关节盂几乎完全恢复，无移植物吸收。与术前测量（分别为 81.6%和 82.4%）相比，术后平均关节盂周长和关节盂面积均升高（分别为 104%和 102.5%）。
本研究结果表明，J 型骨移植技术可成功稳定肩关节，并发症发生率低。可证明骨移植物的重塑，从而导致关节盂表面面积几乎达到 100%的完美程度。
