Clinical outcomes of distal clavicle autograft reconstruction for recurrent anterior shoulder instability

Background and aim The management of recurrent anterior shoulder instability accompanied by glenoid bone loss (GBL) presents a considerable surgical dilemma. Although the Latarjet procedure is widely utilized, it carries a significant risk of complications. The distal clavicle autograft (DCA) has emerged as a viable alternative, providing an osteochondral graft with benefits in terms of accessibility and a favorable safety profile. We aimed to assess the clinical efficacy of the DCA technique. Patients and methods In a prospective study, 20 male patients presenting with recurrent anterior instability and substantial GBL (mean ± 7%) underwent open DCA reconstruction via a deltopectoral approach. Clinical outcomes were evaluated pre and postoperatively using the Rowe score, Constant–Murley score, Visual analog scale for pain, and range of motion assessments over a mean follow-up period of 12 months. Results Statistically significant enhancements were observed across all measured outcomes. The mean Rowe score increased from 21.85 ±6.37 to 90 ±7.95 ( P <0.001), and the mean Constant score improved from 48.2±11.81 to 87.1±8.36 ( P <0.0001). The mean visual analog scale pain score demonstrated a marked reduction from 7.2 ±0.89 to 2.33±0.78 ( P <0.001). Significant gains were also documented in forward flexion, external rotation, and internal rotation (all P <0.0001). Most patients (80%) successfully resumed their preinjury activity levels, with no instances of recurrent dislocation reported. Conclusion The DCA proves to be an effective and dependable technique for addressing recurrent anterior shoulder instability with GBL, yielding superior functional outcomes, notable pain reduction, and restored joint stability.