Combined Distal Tibia and Talus Allograft Reconstruction of Bipolar Glenoid and Humeral Head Bone Loss for Recurrent Anterior Shoulder Instability.

Abstract

Bipolar glenoid and humeral head bone loss can occur with recurrent anterior shoulder instability. Distal tibial allograft or Latarjet coracoid transfer procedures are often used to replace glenoid bone loss in the setting of glenoid deficiency with minimal humeral head bone loss. In the presence of a large humeral Hill-Sachs lesion, however, isolated glenoid reconstruction may not be sufficient to restore the glenoid track. In these cases, concomitant reconstruction of the humeral head bone loss with an osteochondral allograft may be indicated to fully restore glenohumeral stability. The purpose of this report is to describe a technique for combined distal tibia and talus allograft reconstruction of bipolar glenoid and humeral head bone loss for the treatment of recurrent anterior shoulder instability with substantial anterior glenoid and posterosuperior humeral head deficiency.