Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9783-9791
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9783
Scapular bone grafting with allograft pin fixation for repair of bony Bankart lesions: A biomechanical study
Ming Lu, Hai-Peng Li, Yu-Jie Liu, Xue-Zhen Shen, Feng Gao, Bo Hu, Yu-Feng Liu
Ming Lu, Yu-Feng Liu, Medical School of Chinese PLA, Beijing 100853, China
Ming Lu, The Fourth Comprehensive Service and Support Center, The PLA Beijing Administration of Veterans Service Affairs Department, Beijing 100191, China
Hai-Peng Li, Yu-Jie Liu, Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing 100853, China
Xue-Zhen Shen, Capital Medical University Beijing Luhe Hospital, Beijing 100000, China
Feng Gao, National Institute of Sports Medicine, Beijing 100000, China
Bo Hu, The Second Department of Orthopedics, Beijing Chaoyang Integrative Medicine Emergency Medical Center, Beijing 100022, China
Author contributions: Lu M and Liu YJ designed and performed the study; Lu M and Li HP analyzed the data; Lu M wrote the paper and revised the manuscript for final submission; Shen XZ, Gao F, Hu B, and Liu YF participated in the processing of cadaver shoulder joint specimens and biomechanical experiments.
Supported by PLA General Logistics Department, No. CWS14J067.
Institutional review board statement: The study was reviewed and approved by the Chinese PLA General Hospital Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no financial or personal relationships with other individuals or organizations that can inappropriately influence our work and that there is no professional or other personal interest of any nature in any product, service and/or company that could be construed as influencing the position presented in or the review of the manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at email address: 13701356381@163.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Jie Liu, MD, Professor, Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing 100853, China. 13701356381@163.com
Received: June 6, 2021
Peer-review started: June 6, 2021
First decision: July 5, 2021
Revised: August 13, 2021
Accepted: August 27, 2021
Article in press: August 27, 2021
Published online: November 16, 2021
ARTICLE HIGHLIGHTS
Research background

The pathological mechanism of anterior glenohumeral joint dislocation is mostly static stable structural damage. Bony Bankart lesions accounted for 5.4% to 70% of cases of traumatic instability of the glenohumeral joint and 90% of recurrent shoulder dislocations. Bony Bankart lesions lead to scapular glenoid defects, which are often repaired by the Latarjet-Bristow procedure. While good results have been achieved, there are also complications, such as coracoid fracture, bone graft displacement, and vascular and nerve injury.

Research motivation

To avoid the complications caused by the removal of the grafted bone from the coracoid, this study used allograft bone from the scapular spine and the allograft pins to repair and reconstruct bony Bankart lesions of the shoulder joint. To avoid obtaining grafted bone from the coracoid, the complications and medical costs were decreased. In vitro biomechanics experiments were performed.

Research objectives

This study aimed to analyze the technique and biomechanical properties of transversely fixing a bone block from the scapular spine using bone allograft pins with suture threads to repair bony Bankart lesions.

Research methods

Twenty-four fresh human shoulder joint specimens were randomized into a titanium alloy hollow screw repair group, an allograft pin repair group, and a normal control group, with eight shoulders in each group. Model establishment and repair were performed as required, and biomechanical testing was performed using the MTS Tytron 250 system.

Research results

When the angle of external rotation of the humerus was 0°, 30°, 60°, and 90°, with axials loads of 30 N, 40 N, and 50 N, the data of normal control group, allograft pin repair group, and titanium alloy hollow screw repair group, which revealed that there were no statistically significant differences among the three groups (P > 0.05).

Research conclusions

The joints repaired with bone block from the scapular spine transversely fixed with allograft bony pins to repair bony Bankart lesions show good mechanical stability.

Research perspectives

This new method is conducive to treating injury post-surgery, is feasible, reduces medical costs, and is expected to be popularized and applied in the clinic.