A pilot study of the effectiveness of the biological stimulation of bone block remodeling in the Bristow – Latarge operation
- Authors: Tregubov A.S.1, Malanin D.A.1, Suchilin I.A.1, Zhulikov A.L.1, Demeshchenko M.V.1
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Affiliations:
- Volgograd State Medical University
- Issue: Vol 22, No 4 (2025)
- Pages: 165-172
- Section: Original Researches
- URL: https://ogarev-online.ru/1994-9480/article/view/375663
- DOI: https://doi.org/10.19163/1994-9480-2025-22-4-165-172
- ID: 375663
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Full Text
Abstract
Introduction: Recurrent anterior shoulder dislocation is a common consequence of traumatic injuries associated with structural defects of the anteroinferior glenoid. The Bristow – Latarjet procedure remains one of the most effective surgical techniques for restoring glenohumeral stability by transferring the coracoid process to reconstruct the anterior bony buttress. However, postoperative resorption of the coracoid bone graft occurs in a substantial proportion of patients even when the procedure is performed correctly. This process may compromise the stability of the shoulder joint and increase the risk of recurrent instability. Consequently, biological methods aimed at enhancing osteointegration have gained growing attention, particularly the use of autologous bone marrow aspirate clot (BMAC), which contains mesenchymal stromal cells and osteoinductive factors capable of supporting bone healing.
The aim of the study: To assess the effect of BMAC application on the remodeling of the bone graft following the Bristow – Latarjet procedure and to compare postoperative changes in bone density and graft volume with the classical surgical technique.
Materials and methods: A prospective study included 22 patients with recurrent anterior shoulder dislocation. The patients were divided into two equal groups: the main group (n = 11), in which BMAC was applied to the graft surface, and the comparison group (n = 11), who underwent the conventional procedure. Bone marrow aspirate was harvested from the iliac crest and converted into a coagulated clot fixed onto the graft. Multislice computed tomography was performed at 2 days, 2 months, and 6 months postoperatively. Bone mineral density (HU) was measured at three anatomical levels, and graft volume was assessed via 3D reconstruction.
Results: The main group demonstrated a slower decline in bone density and significantly reduced graft resorption. At 6 months, the graft volume remained at (1.23 ± 0.11) cm³, compared with a nearly twofold reduction in the comparison group – (0.74 ± 0.25) cm³. Bone density above and between the screws decreased less markedly in the BMAC group, suggesting enhanced osteointegration and more active remodeling. The use of BMAC did not increase surgical duration, technical complexity, or complication rates.
Conclusion: The application of BMAC improves the biological environment for graft osteointegration and reduces the degree of graft resorption after the Bristow – Latarjet procedure. This technique is safe, technically feasible, and may significantly enhance the reliability of anterior glenoid reconstruction. Further randomized clinical studies are required to confirm these findings and determine the role of BMAC in standard treatment protocols for anterior shoulder instability.
About the authors
Andrey S. Tregubov
Volgograd State Medical University
Author for correspondence.
Email: as.tregubov@yandex.ru
Assistant Professor of the Department of Traumatology, Orthopedics and Military Field Surgery
Russian Federation, VolgogradDmitry A. Malanin
Volgograd State Medical University
Email: malanin67@mail.ru
ORCID iD: 0000-0001-7507-0570
MD, Head of the Department of Traumatology, Orthopedics and Military Field Surgery, Professor
Russian Federation, VolgogradIlya A. Suchilin
Volgograd State Medical University
Email: iljasuchilin@yandex.ru
ORCID iD: 0000-0001-7375-5365
Candidate of Medical Sciences, Associate Professor of the Department of Traumatology, Orthopedics and Military Field Surgery
Russian Federation, VolgogradAlexander L. Zhulikov
Volgograd State Medical University
Email: julikov60@mail.ru
Candidate of Medical Sciences, Associate Professor of the Department of Traumatology, Orthopedics and Military Field Surgery
Russian Federation, VolgogradMaxim V. Demeshchenko
Volgograd State Medical University
Email: maximus275@yandex.ru
ORCID iD: 0000-0003-1797-2431
Candidate of Medical Sciences, Associate Professor of the Department of Traumatology, Orthopedics and Military Field Surgery
Russian Federation, VolgogradReferences
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