Zhang Jeffrey A, Lam Patrick, Beretov Julia, Murrell George A C
UNSW Faculty of Medicine, Kensington, Sydney, NSW 2033, Australia.
Orthopedic Research Institute, St. George Hospital, Kogarah, Sydney, NSW 2217, Australia.
J Clin Med. 2023 Jun 13;12(12):4035. doi: 10.3390/jcm12124035.
We intended to determine if an acromion or distal clavicle bone graft could restore large glenoid defects using two novel, screw-free graft fixation techniques.
Twenty-four sawbone shoulder models were divided into four groups (n = 6 per group) according to fixation technique and bone graft: (1) modified buckle-down technique with clavicle graft, (2) modified buckle-down technique with acromion graft, (3) cross-link technique with acromion graft, (4) cross-link technique with clavicle graft. Testing was performed sequentially in (1) intact models, (2) after creation of a 30% by-width glenoid defect and (3) after repair. The shoulder joint was translated anteriorly, and glenohumeral contact pressures and load were measured to quantify the biomechanical stability.
Maximum contact pressures were restored to 42-56% of intact glenoid using acromion and clavicle grafts with novel fixation techniques. Acromion grafts attained higher maximum contact pressures than clavicle grafts in all groups. Peak translational forces increased by 171-368% after all repairs.
This controlled laboratory study on sawbone models found that both the acromion and distal clavicle are suitable autologous bone graft options for treating large anterior glenoid defects, having appropriate dimensions and contours for reconstructing the glenoid arc. The modified buckle-down and cross-link techniques are two graft fixation techniques that restore stability to the shoulder joint upon repairing a large glenoid defect and are advantageous in being screw-free and simple to execute.
我们旨在确定使用两种新型无螺钉植骨固定技术，肩峰或锁骨远端骨移植能否修复大型关节盂缺损。
根据固定技术和骨移植情况，将24个带锯骨的肩部模型分为四组（每组n = 6）：（1）锁骨移植改良扣压技术，（2）肩峰移植改良扣压技术，（3）肩峰移植交联技术，（4）锁骨移植交联技术。依次在（1）完整模型、（2）制造30%宽度的关节盂缺损后以及（3）修复后进行测试。向前平移肩关节，测量盂肱接触压力和负荷以量化生物力学稳定性。
使用新型固定技术的肩峰和锁骨移植，最大接触压力恢复至完整关节盂的42% - 56%。在所有组中，肩峰移植获得的最大接触压力高于锁骨移植。所有修复后，峰值平移力增加了171% - 368%。
这项对带锯骨模型进行的对照实验室研究发现，肩峰和锁骨远端都是治疗大型前侧关节盂缺损合适的自体骨移植选择，它们具有合适的尺寸和轮廓来重建关节盂弧。改良扣压和交联技术是两种在修复大型关节盂缺损时能恢复肩关节稳定性的植骨固定技术，其优点是无螺钉且操作简单。
