[Effectiveness of arthroscopic autologous iliac bone grafting with double-row elastic fixation for recurrent anterior shoulder dislocation with massive glenoid bone defect].

Objective: To investigate the effectiveness of arthroscopic autologous iliac bone grafting with double-row elastic fixation in treatment of recurrent anterior shoulder dislocation combined with massive glenoid bone defects. Methods: Between January 2018 and December 2021, 16 male patients with recurrent anterior shoulder dislocation combined with massive glenoid bone defects were treated with arthroscopic autogenous iliac bone grafting and double-row elastic fixation. The patients were 14-29 years old at the time of the first dislocation, with an average age of 18.4 years. The causes of the first dislocation included falling injury in 5 cases and sports injury in 11 cases. The shoulders dislocated 4-15 times, with an average of 8.3 times. The patients were 17-37 years old at the time of admission, with an average age of 25.1 years. There were 5 left shoulders and 11 right shoulders. The preoperative instability severity index (ISIS) score of the shoulder joint was 5.8±2.1, and the Beighton score was 4.3±2.6. The University of California Los Angeles (UCLA) score, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and Rowe score were used to evaluate shoulder function, and the degree of the glenoid bone defect repair was observed based on CT after operation. Results: All incisions healed by first intention, and no complication such as incision infection or neurovascular injury occurred. The patients were followed up 12 months. At 12 months after operation, UCLA score, Constant score, ASES score, and Rowe score all significantly improved when compared with the scores before operation ( P<0.05). CT imaging showed the degree of glenoid bone defect was significantly smaller at immediate, 6 and 12 months after operation when compared with that before operation ( P<0.05), and the bone blocks healed with the scapula, and bone fusion had occurred at 12 months. Conclusion: Arthroscopic autologous iliac bone grafting with double-row elastic fixation is a safe treatment for recurrent anterior shoulder dislocation combined with massive glenoid bone defects, with good short-term effectiveness.

Patellar Tendon Reconstruction Using Autologous Hamstring Tendons for the Treatment of Extensive Patellar Tendon Ossification.

BACKGROUND: Extensive patellar tendon ossification is very uncommon and requires surgical intervention when ossification significantly affects knee function. While various approaches and grafts are available for reconstructing ruptured patellar tendons, there is a paucity of literature regarding the management of joint ankylosis due to severely ossified patellar tendons. CASE PRESENTATION: This is a case involving an extensively ossified patellar tendon after patellar and tibial tuberosity fracture fixation. Reconstruction of the patellar tendon was performed using ipsilateral semitendinosus and gracilis autografts. At the latest follow-up of 12 months, the patient achieved knee flexion up to 120° with a slight extension lag and resumed daily activities. CONCLUSIONS: Autograft hamstring reconstruction of the patellar tendon is suitable for extensive heterotopic ossification of the patellar tendon, resulting in significant improvement in postoperative knee function. Similar patients may be referred for this reconstruction technique.

Autogenous iliotibial band enhancement combined with tendon lengthening plasty to treat patella baja: A case report.

BACKGROUND: Patella baja is a severe complication after knee injury or surgery, resulting in pain and impaired movement. This disorder is also a substantial challenge for orthopaedic surgeons. Currently, no consensus exists regarding the gold standard management of patella baja. If not appropriately treated, significant dysfunction of the knee joint will occur. CASE SUMMARY: A 46-year-old man with a left patellar fracture was treated with tension band fixation at a local hospital. He had undergone a second operation at the same hospital because of limited knee flexion 6 mo after surgery. Unfortunately, the patellar tendon was ruptured. The patellar tendon was subsequently repaired using an ipsilateral semitendinosus tendon. Two years later, the patient presented to our department with knee pain and loss of range of motion. Autogenous iliotibial band (ITB) enhancement combined with sagittal tendon lengthening plasty was used to improve the symptoms of the knee joint. The patient was followed up for 2 years. The knee joint function of the patient returned to the normal level. CONCLUSION: We successfully treated patella baja using autogenous ITB enhancement combined with sagittal tendon lengthening plasty.