Arthroscopic distal clavicle autograft with suture button fixation for shoulder instability with glenoid bone loss: a case series.
BACKGROUND: Distal clavicle autograft (DCA) has garnered increasing popularity as a cost-effective and safe autograft for glenoid reconstruction in shoulder instability. The purpose of this study is to report the clinical outcomes of a single-surgeon case series of patients managed with arthroscopic DCA for glenoid bone loss with suture button fixation at minimum follow-up of 1 year. METHODS: All cases of recurrent anterior glenohumeral instability treated with DCA by a single surgeon between January 2020 and December 2023 were reviewed. Patients were included if DCA was performed arthroscopically with 2 suture buttons for fixation, with minimum clinical follow-up of 1 year. Patients were evaluated post-operatively for recurrent instability or complications. Glenoid bone loss was measured using 3-dimensional reconstruction and best-fit circle methods on pre-operative computed tomography scans. Coracoclavicular (CC) distances were measured pre-operatively and post-operatively to assess for acromioclavicular joint instability and change in preoperative to post-operative CC distance was assessed with dependent t-test. RESULTS: Eight patients were included. Average age was 32.6 years. There were 7 males and 1 female. At surgery, mean glenoid bone loss was 23.3% (range: 17.8%-30.8%). At harvest, the average length, thickness, and width of the DCA were 22.8 mm, 11.6 mm, and 11.3 mm, respectively. After preparation, the graft averaged 22.8 mm in length with a width and depth of 10 mm, respectively. At a mean follow-up of 2.6 years (range: 1.5-4.0 years), no patients had recurrent subluxation or dislocation. No evidence of CC ligament damage was noted; average preoperative and post-operative CC distances were 11.5 mm and 11.3 mm, respectively, with mean change of -0.7 mm (95% confidence interval: -4.8 to +3.4 mm, P = .69). One patient was noted to have one loose posterior extracapsular button without clinical complication. No other complications were noted. CONCLUSION: In this case series of patients who underwent arthroscopic glenoid reconstruction with DCA, we noted low complication rates and no evidence of recurrent instability.
