Arthroscopic anatomic glenoid reconstruction demonstrates its safety with short-term to medium-term results for anteroinferior shoulder instability: a systematic review
Bibliographic record
Abstract
What is already known► Arthroscopic anatomic glenoid reconstruction (AAGR) is a relatively recently described surgical treatment option for patients with shoulder instability and bone loss.► There are numerous technique papers and several studies with short-term to medium-term results.What are the new findings ► This study summarises the techniques that have been described in the literature for AAGR.► It also provides critical analysis of the results available to date.► It demonstrates that this is a safe procedure with results that encourage long-term study.► The observations from this review could help to guide future studies, particularly in terms of graft selection and fixation techniques in this evolving technique for managing shoulder instability.AbSTrACT Importance Glenoid bone loss can be associated with recurrent anterior shoulder instability and can lead to unsuccessful stabilisation procedures if not addressed.Objective The purpose of this study was to review the currently described techniques for arthroscopic anatomic glenoid reconstruction (AAGR) for anteroinferior shoulder instability and to analyse the results available to date.Evidence review A systematic literature search of three databases (PubMed, Embase and Scopus) was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify relevant articles.Any article describing a surgical technique and/or presenting results related to this technique was included.Quality appraisal was performed using the Risk Of Bias In Non-randomised Studies-of Interventions tool and the Institute of Health Economics Quality Appraisal of Case Series Studies Checklist.Findings Twenty-seven studies published between 2008 and 2019 were identified for inclusion.Clinical results were available for a total of 237 patients across all studies, with age range 16-67.Iliac crest autograft was used in 60% of patients.Iliac crest allograft and distal tibia allograft were used in 22% and 18% of patients, respectively.Distal clavicle autograft, lateral femoral autograft, glenoid allograft and synthetic graft were also described in cadaveric studies or technique papers without results.Capsuloligamentous repair was performed with suture anchors in 95% of patients, while 5% had no soft-tissue repair.Patient satisfaction was high (90%), with low rates of instability (5%).Clinical exam demonstrated satisfactory range of motion, with good outcomes when functional scores were assessed, including Rowe score, constant score, Walch-Duplay score, Western Ontario Shoulder Instability Index (WOSI)and subjective shoulder value.Radiographic evaluation revealed high union rates (97%), but also high rates of resorption.Graft resorption rates averaged between 10% and 32%.Conclusions Current evidence demonstrates that AAGR is a safe procedure with good short-term to mediumterm results that is worthy of further study. Level of evidence Level IV, systematic review of level III and IV studies.Were patients recruited consecutively?Unclear Unclear Yes
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".