The scapula spine may not be a suitable source of bone graft for glenoid reconstruction in critical bone loss.

Abstract

The hypothesis is that the scapula spine can provide a graft of suitable dimensions for use in cases of shoulder instability with critical bone loss. We aimed to investigate its utility with grafts of differing sizes. The scapula spine was measured on computed tomography scans of 50 patients who had undergone anterior stabilization. The theoretical ability to harvest a graft of either 2 × 1 × 1 cm or 2 × 0.8 × 0.8 cm was analyzed. Using the 2 × 1 × 1 cm threshold, 36% of the scapulae had at least 1 zone from which a suitable graft could be obtained. 61% had only 1 zone from which a suitable graft could be obtained. Using the 2 × 0.8 × 0.8 cm threshold, 72% had at least 1 zone from which a graft could be obtained. A total of 47% met the threshold in 1 zone only. The scapula spine can be used as a source of autograft. Grafts up to 2 x 1 × 1 cm can be harvested in some individuals; however, the anatomy is very variable.