Bone block options for treating glenoid bone loss and glenohumeral instability: A systematic review.

Abstract

To systematically review the literature assessing glenoid bone loss restoration by different bone block options and compare their dimensions. Systematic examination of articles in PubMed and EMBASE databases was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to find studies of bone grafts for treating anterior glenohumeral instability. Statistical analyses were conducted via Review Manager, and a <i>p</i>-value of <0.05 was statistically significant. Our review included 25 studies evaluating 870 shoulders. Traditional arc Latarjet (TL) had more depth than congruent arc Latarjet (CAL; <i>p</i> = 0.003). The coronal radii of curvature of TL, CAL, distal tibia, and iliac crest bone blocks were similar to native glenoid (<i>p</i> = 0.400, 0.817, 0.467, 0.216, respectively). CAL coracoid bone blocks restored significantly more glenoid surface area (30.3%) than TL bone blocks (<i>p</i> = 0.012). The glenoid width and surface area restoration by distal clavicle bone blocks were equivalent to TL (<i>p</i> = 0.058 and <i>p</i> = 0.103, respectively). The CAL technique restored higher percentages of glenoid surface area than TL but has less depth, which may increase fracture risk during screw insertion. The distal clavicle bone block is a suitable substitute to TL as it was equivalent regarding glenoid width and surface area restoration.