The Eden-Hybinette procedure is the most common surgery for revision of a failed Latarjet procedure. When there are greater degrees of glenoid bone loss, the Latarjet procedure may not be sufficient to ensure adequate stability. This is an open or arthroscopic procedure that uses an iliac crest bone graft to reconstitute glenoid bone loss.
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Indications
severe glenoid bone loss (>40%)
recurrent instability following a Latarjet procedure
recurrent anterior shoulder dislocation in patients with epilepsy
patients with abnormal coracoid morphology
unreconstructable glenoid fracture with subluxation or severe instability
Contraindications
uncontrolled seizures
active infections
Radiographic features
Pre-operative
CT of the scapula with 3D reconstruction to calculate the amount and morphology of glenoid bone loss.
Post-operative
Immediate postoperative radiograph to evaluate the position of the screws (often two oriented parallel to the articular surface) and the position of the tricortical bone graft, because if the graft is positioned too laterally, there is risk of developing progressive arthritis.
Follow-up imaging as a baseline study to which all future studies are compared to, is performed at 3–6 weeks after surgery to exclude complication as non-union, screw breakage/migration graft and osteolysis. It include true anteroposterior (AP) or Grashey view, axillary and lateral scapula view.
A CT scan after 6 months to confirm graft union.
History and etymology
It was first described by Rudolf Theiss Eden in 1917 that proposed the transfer a bone block from the tibia to the scapular neck. Subsequently Samuel Hybinette introduced a new technique using a tricortical iliac bone autograft.