Richard Cunningham, MD, is a board certified orthopedic surgeon and sports medicine specialist with a clinical focus on treatment of shoulder conditions. Patients diagnosed with a history of recurrent shoulder dislocations, or repeat failed shoulder surgeries to stabilize the shoulder, may be a candidate for Dr. Cunningham’s distal tibial allograft (DTA) for glenoid reconstruction surgeries. This is a complex surgical procedure requiring a high degree of training and expertise.
Dr. Cunningham’s experience, skill, and specialized training makes him one of the best shoulder surgeons in Colorado to perform this complex shoulder surgery. After this procedure, many patients report improved shoulder stability and function.
What is Distal Tibial Allograft for Glenoid Reconstruction?
The glenoid, or socket portion of the shoulder joint, is subject to bone loss as a result of recurrent shoulder dislocations. As a result of the humeral head dislocating forcefully out of the socket, the socket bone can be chipped along its edge. As a result of further dislocations, more and more of the socket bone can be worn away. This is called a Bony Bankart Fracture. When glenoid bone loss is greater than 17%, Dr. Cunningham may recommend a distal tibial allograft (donor graft) glenoid reconstruction to rebuild the glenoid bone and therefore improve overall shoulder stability.
This is an open surgery which involves harvesting, preparing, and transplanting a section of bone from the lower end of a donor tibia (shin bone). Fortunately, this portion of the bone nicely matches the front end of the glenoid. This donor bone also has cartilage on its surface thus replacing not only the bone that has been lost but also the overlying cartilage. Preparing the shoulder socket for transplantation involves:
- Removal of the damaged soft tissues on the front aspect of the socket
- Sizing and shaping of the donor bone piece to precisely fit the patient’s unique glenoid socket
Once preparation is complete, the graft is implanted and secured in position using 2 surgical screws.
Benefits of Distal Tibial Allograft For Glenoid Reconstruction
Distal tibial allograft for glenoid reconstruction provides several advantages for patients. Utilizing a donor tibial bone graft ensures optimal fit, durability and a natural replacement solution for damaged or missing glenoid bone and cartilage. Benefits of utilizing a distal tibial allograft are:
- Similar size and shape of glenoid bone
- Strong, supportive bone surface and overlying cartilage
- Adaptable to forces and stresses seen in the shoulder joint
Dr. Cunningham works closely with each patient to evaluate the benefits of a distal tibial allograft glenoid reconstruction. The risks and benefits are unique for each patient; overall health, activity level, diagnostic findings, lifestyle needs and circumstances. With any surgery, complications are considered; post surgery infection, nerve damage, and implant failure are rare but possible.
Indications for Distal Tibial Allograft for Glenoid Reconstruction
Dr. Cunningham’s expertise and patient evaluation procedure determines the individual indications of DTA for patients experiencing significant damage to the glenoid and recurrent shoulder dislocations. He has a complete understanding of the anatomical and biomechanical factors pertinent to the individual patient. As part of surgical planning, Dr. Cunningham obtains an MRI and CT of the shoulder. The findings, professional opinion, and relevant patient factors inform his recommendation. Patient factors include:
- Age – The younger the patient the greater the indication for this long-lasting solution as the risks of more shoulder dislocations doing further damage is higher
- Bone health – Strong healthy bone will provide a supportive structure for the recovery process
- Overall health – Absence of conditions that may interfere with healing
- Commitment – Physical therapy and a lengthy rehabilitation are required for a successful outcome
- Expectations – Accurate understanding of recovery process and outcomes
Dr. Cunningham provides a comprehensive evaluation process for potential shoulder surgery patients. The doctor and patient decide together whether distal tibial allograft glenoid reconstruction is indicated. Request a consultation with one of the best shoulder surgeons in Colorado, Richard Cunningham, MD today. In Vail, CO at: (970) 476-2451, in Frisco, CO at: (970) 668-3633, and in Edwards, CO at: (970)-569-3240.