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dc.contributor.author
Sigrist, Bastian
dc.contributor.author
Ferguson, Stephen
dc.contributor.author
Boehm, Elisabeth
dc.contributor.author
Jung, Christian
dc.contributor.author
Scheibel, Markus
dc.contributor.author
Moroder, Philipp
dc.date.accessioned
2020-07-08T10:37:00Z
dc.date.available
2020-06-03T18:12:35Z
dc.date.available
2020-06-04T12:16:30Z
dc.date.available
2020-07-08T10:37:00Z
dc.date.issued
2020-07-01
dc.identifier.issn
0363-5465
dc.identifier.issn
1552-3365
dc.identifier.other
10.1177/0363546520919958
en_US
dc.identifier.uri
http://hdl.handle.net/20.500.11850/418010
dc.description.abstract
Background: Individual constitutional differences in glenoid shape and bone remodeling require a patient-specific and longitudinal approach to evaluate the biomechanical effects of glenoid bone grafting in patients with anterior shoulder instability. Purpose: To quantify the longitudinal, in vivo, biomechanical effects of bone grafting, bone graft remodeling, and glenoid shape in patients with anterior shoulder instability by means of patient-specific finite element models. Study Design: Descriptive laboratory study. Methods: In total, 25 shoulders of 24 patients with anterior shoulder instability and anterior glenoid bone loss underwent an arthroscopic iliac crest bone graft transfer (ICBGT) procedure with either autologous or allogenic bone. Patient-specific finite element simulations based on preoperative, postoperative, and follow-up computed tomography scans were used to quantify the bone-mediated stability ratio (SR) and the distance to dislocation. Additionally, the relationship between glenoid morphological parameters and the SR was assessed. Results: The ICBGT procedure significantly increased the SR and distance to dislocation in the 2-, 3-, and 4-o’clock directions immediately after the surgical intervention (P < .01) in both the autograft and the allograft groups. Although the SR and distance to dislocation decreased subsequently, autografts showed long-term effects on SR and dislocation distance in the 3-o’clock direction (P < .01) and on SR in the 4-o’clock direction (P < .01). Allografts showed no significant effect on SR and dislocation distance in long-term follow-up (P > .05). Overall, glenoid retroversion as well as cavity depth predicted stability in all 4 dislocation directions, with glenoid cavity depth showing the highest correlation coefficients (R = 0.71, 0.8, 0.73, and 0.7 for 2-, 3-, 4-, and 5-o’clock, respectively). Conclusion: The autologous ICBGT procedure biomechanically improved anterior shoulder stability in long-term follow-up, whereas the use of allografts did not show any bone-mediated biomechanical effect at follow-up due to resorption. Furthermore, in addition to measurements of defect extent, the glenoid depth and version seem to be useful parameters to determine the biomechanical effect and need for glenoid bone grafting in patients with shoulder instability. Clinical Relevance: This study proposes the use of autologous bone grafts for a successful long-term stabilization effect. Additionally, this study proposes additional glenoid morphological measures to predict shoulder stability.
en_US
dc.language.iso
en
en_US
dc.publisher
Sage
en_US
dc.subject
Shoulder instability
en_US
dc.subject
Iliac crest bone graf
en_US
dc.subject
Allograft
en_US
dc.subject
Autograft
en_US
dc.subject
Remodeling
en_US
dc.title
The Biomechanical Effect of Bone Grafting and Bone Graft Remodeling in Patients With Anterior Shoulder Instability
en_US
dc.type
Journal Article
dc.date.published
2020-05-21
ethz.journal.title
The American Journal of Sports Medicine
ethz.journal.volume
48
en_US
ethz.journal.issue
8
en_US
ethz.journal.abbreviated
Am J Sports Med
ethz.pages.start
1857
en_US
ethz.pages.end
1864
en_US
ethz.identifier.wos
ethz.identifier.scopus
ethz.publication.place
Thousand Oaks, CA
en_US
ethz.publication.status
published
en_US
ethz.leitzahl
ETH Zürich::00002 - ETH Zürich::00012 - Lehre und Forschung::00007 - Departemente::02070 - Dep. Gesundheitswiss. und Technologie / Dep. of Health Sciences and Technology::02518 - Institut für Biomechanik / Institute for Biomechanics::03915 - Ferguson, Stephen / Ferguson, Stephen
ethz.leitzahl.certified
ETH Zürich::00002 - ETH Zürich::00012 - Lehre und Forschung::00007 - Departemente::02070 - Dep. Gesundheitswiss. und Technologie / Dep. of Health Sciences and Technology::02518 - Institut für Biomechanik / Institute for Biomechanics::03915 - Ferguson, Stephen / Ferguson, Stephen
ethz.date.deposited
2020-06-03T18:12:39Z
ethz.source
WOS
ethz.eth
yes
en_US
ethz.availability
Metadata only
en_US
ethz.rosetta.installDate
2020-07-08T10:37:17Z
ethz.rosetta.lastUpdated
2021-02-15T15:21:41Z
ethz.rosetta.versionExported
true
ethz.COinS
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