{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:11:06Z","timestamp":1793135466977,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T00:00:00Z","timestamp":1482364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T00:00:00Z","timestamp":1482364800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T00:00:00Z","timestamp":1482364800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the clinical and radiographic outcomes of patients with recurrent anterior shoulder instability treated with fresh distal tibia allograft (DTA) glenoid reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive patients with a minimum 15% anterior glenoid bone loss associated with recurrent anterior instability who underwent stabilization with DTA glenoid reconstruction were retrospectively reviewed. Patients were evaluated with the American Shoulder and Elbow Society score, Western Ontario shoulder instability index, and single numerical assessment evaluation score at a minimum 2\u00a0years after surgery. All patients also underwent postoperative imaging evaluation with computed tomography where graft incorporation and allograft angle were measured. Statistical analysis was performed with paired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, with\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05 considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 27 patients (100% male) with an average age of 31 \u00b1 5\u00a0years and an average follow\u2010up of 45\u00a0months (range, 30\u201066) were included. There were significant improvements in preoperative to postoperative American Shoulder and Elbow Society score (63\u201091,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01), Western Ontario shoulder instability index (46% to 11% of normal,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01), and single numerical assessment evaluation score (50\u201090.5,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01) outcomes. Analysis of computed tomography data at an average 1.4\u00a0years postoperatively (available for 25 patients) showed an allograft healing rate of 89% (range, 80% to 100%), average allograft angle of 14.9\u00b0 (range, 6.6\u00b0 to 29.3\u00b0), and average allograft lysis of 3% (range, 0% to 25%). Grafts with lesser allograft angles (&lt;15\u00b0) were better opposed to the anterior glenoid, showing superior healing and graft incorporation. There were no cases of recurrent instability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At an average follow\u2010up of 45\u00a0months, fresh DTA reconstruction for recurrent anterior shoulder instability results in a clinically stable joint with excellent clinical outcomes and minimal graft resorption. Optimal allograft placement resulted in superior bony incorporation with the native glenoid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, therapeutic case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2016.09.029","type":"journal-article","created":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T21:06:36Z","timestamp":1482440796000},"page":"891-897","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":167,"title":["Distal Tibia Allograft Glenoid Reconstruction in Recurrent Anterior Shoulder Instability: Clinical and Radiographic Outcomes"],"prefix":"10.1002","volume":"33","author":[{"given":"Matthew T.","family":"Provencher","sequence":"first","affiliation":[{"name":"The Steadman Clinic and Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Golijanin","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth Hanover New Hampshire U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil N.","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony A.","family":"Romeo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,22]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00906"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200908000-00002"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.11.016"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2013.10.005"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.10.017"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.03.006"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514545860"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.00220"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513490646"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2013.11.029"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2607-x"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512458247"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.10.008"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200305000-00016"},{"key":"e_1_2_2_16_2","doi-asserted-by":"crossref","unstructured":"Frank RM Romeo AA Provencher MT. 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