Excellent clinical and radiological mid-term outcomes of the arthroscopic “double-inlay” Eden-Hybinette procedure for bone defects exceeding 20%: a 5-year case series

Abstract

Background

Eden-Hybinette procedure can maximize the restoration of the glenoid defect by harvesting a proper size of iliac bone block. We developed an arthroscopic “double-inlay” Eden-Hybinette procedure to achieve better bone union of the graft. The aim of this study was to evaluate the clinical and radiological mid-term outcomes of the arthroscopic “double-inlay” Eden-Hybinette procedure for bone defects exceeding 20%.

Methods

A retrospective case series was conducted. The inclusion criterion was a bone defect exceeding 20%, especially failed Bristow-Latarjet procedure or recurrent anterior shoulder instability among patients with epilepsy. An arthroscopic “double-inlay” Eden-Hybinette procedure was carried out. Recurrence and apprehension, the American Shoulder and Elbow Surgeons, University of California at Los Angeles, Subjective Shoulder Value, Rowe, and visual analog scale pain scores and rate of return to sports were obtained at final follow-up. Graft position, healing, and resorption were evaluated via 3D computerized tomography scan. Moreover, postoperative complications and the incidence of osteoarthritis were recorded.

Results

The study cohort included 15 patients, with a mean age of 34.9 ± 13.2 years (range, 19-59 years) and a mean follow-up duration of 5 ± 1.7 years (range, 2.0-8.0 years). No patients experienced recurrent dislocation, and the visual analog scale pain and instability scores during shoulder range of motion decreased from a mean 6.5 ± 2.3 and 9.6 ± 0.9 preoperatively to 1.9 ± 1 and 2 ± 1.7 at the last follow-up (P < .001). The Rowe, American Shoulder and Elbow Surgeons, University of California at Los Angeles, and Subjective Shoulder Value scores of the patients increased from 18.7 ± 10.6, 71.8 ± 5, 22.9 ± 3.5, and 49.3 ± 16.2 preoperatively to 90.3 ± 6.2, 90.1 ± 4.2, 30.1 ± 2.4 (P < .001) and 81.1 ± 15.7 (P = .001) postoperatively. At the final follow-up, the bone graft healing rate was 100%, and there was no severe bone resorption. All patients returned to work, and 73.3% of patients (11 of 15) returned to sports at their preinjury or higher level.

Conclusions

The arthroscopic “double-inlay” Eden-Hybinette procedure has demonstrated reliability and efficacy, yielding excellent mid-term clinical and radiological outcomes for bone defects exceeding 20%, particularly in cases of failed Bristow-Latarjet procedures or in patients with epilepsy.