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

Background: To systematically review the literature assessing glenoid bone loss restoration by different bone block options and compare their dimensions.

Methods: 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 p-value of <0.05 was statistically significant.

Results: Our review included 25 studies evaluating 870 shoulders. Traditional arc Latarjet (TL) had more depth than congruent arc Latarjet (CAL; p = 0.003). The coronal radii of curvature of TL, CAL, distal tibia, and iliac crest bone blocks were similar to native glenoid (p = 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 (p = 0.012). The glenoid width and surface area restoration by distal clavicle bone blocks were equivalent to TL (p = 0.058 and p = 0.103, respectively).

Discussion: 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.