Universität zu Köln

Hackl, Michael ORCID: 0000-0002-6183-5621, Knowles, Nikolas K., Wegmann, Kilian, Mueller, Lars Peter, Athwal, George S. and King, Graham J. W. (2021). Coronoid process reconstruction with a distal clavicle autograft: an in silico analysis of fitting accuracy. J. Shoulder Elbow Surg., 30 (6). S. 1282 - 1288. NEW YORK: MOSBY-ELSEVIER. ISSN 1532-6500

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Abstract

Background: The coronoid process plays a vital role in preserving elbow stability. In cases of acute or chronic deficiency of the coronoid process, reconstruction is warranted to restore stability and to avoid early joint degeneration. The distal clavicle might be a useful osteochondral autograft for coronoid reconstruction with low donor-site morbidity. This study evaluated the fitting accuracy of the distal clavicle as an autograft for coronoid process reconstruction. Methods: One hundred upper-extremity computed tomography scans of 85 body donors were available for this study (mean age, 69 +/- 17 years; 46 male and 39 female donors; 15 bilateral specimens). Standardized 40% transverse defects of the coronoid process were digitally created; the distal clavicles were digitally harvested and placed onto the defects by a best-fit technique in 2 different orientations using commercially available software: (1) with the superior aspect of the articular surface of the graft oriented toward the coronoid tip and (2) with the inferior aspect of the articular surface of the graft oriented toward the coronoid tip. The fitting accuracy of the grafts to the native coronoid process was evaluated from lateral to medial using custom code. Results: Regardless of the orientation of the graft, the distal clavicle provided a good fit in the central portion of the coronoid process. In the lateral and medial aspects of the defect, however, the fitting accuracy of the graft declined significantly (P <= .044). No significant differences were observed between ipsilateral and contralateral grafts (P >= .199). The intrarater reliability was excellent. Conclusion: The results of this study suggest that a distal clavicle autograft may be suitable to replace a transverse defect of the coronoid process; however, it may not fully reconstruct the anteromedial and anterolateral aspects of the coronoid. (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, Michael UNSPECIFIED orcid.org/0000-0002-6183-5621 UNSPECIFIED Knowles, Nikolas K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Athwal, George S. UNSPECIFIED UNSPECIFIED UNSPECIFIED King, Graham J. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-579589
DOI:	10.1016/j.jse.2020.09.013
Journal or Publication Title:	J. Shoulder Elbow Surg.
Volume:	30
Number:	6
Page Range:	S. 1282 - 1288
Date:	2021
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1532-6500
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSTEROMEDIAL ROTATORY INSTABILITY; LATERAL COLLATERAL LIGAMENT; GLENOID BONE LOSS; ELBOW; FRACTURES; GRAFT; STABILITY; DISLOCATION; PROSTHESIS; INJURY Multiple languages Orthopedics; Sport Sciences; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57958