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Shoulder: Cartilage and bone transplants in the shoulder

Introduction

Shoulder pain and dysfunction due to degenerative changes or trauma can have a significant impact on quality of life. While traditional treatments often rely on pain management or, in severe cases, total joint replacement, modern orthopaedic advances now offer biological reconstruction techniques such as cartilage grafting and bone grafting.

These innovative procedures make it possible to restore the natural joint structure and function.

Shoulder: Cartilage and bone transplants in the shoulder

What is a cartilage transplant and how does it help?

Cartilage transplantation is used to repair damaged joint surfaces by replacing the damaged cartilage with healthy tissue. This method is particularly beneficial for younger and active patients who want to preserve their natural joint instead of needing a prosthesis.

Types of cartilage transplantation

  • Autologous chondrocyte implantation (ACI) - cartilage cells are removed, cultivated in the laboratory and reimplanted into the defect.
  • Osteochondral allotransplantation (OCA) - donor cartilage and bone are used to cover defects.
  • Microfracture technique - small drill holes stimulate the growth of fibrocartilage (poorer long-term results).
  • Matrix-induced autologous chondrocyte implantation (MACI) - Similar to ACI, but with a collagen matrix to support cartilage growth.

Advantages of cartilage transplantation

  • Preservation of the natural joint
  • Pain relief and improved mobility
  • Delay or avoidance of joint replacement
  • Ideal for younger patients with localized cartilage damage
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Bone grafting to restore structural defects

Bone transplants are necessary when shoulder instability due to significant bone defects, e.g. in exists, e.g. in the case of recurrent dislocations or fractures.

Types of bone grafting

  • Autografts - bones from the patient's own body (e.g. iliac crest).
  • Allografts - donor bones from a tissue bank.
  • Synthetic bone substitutes - Artificial materials that promote bone growth.

Surgical techniques for bone grafting

  • Latarjet surgery - transfer of part of the coracoid process to reinforce the joint socket.
  • Eden-Hybinette procedure - iliac crest bone grafting for the reconstruction of bone defects.
  • Osteochondral transplantation - combination of cartilage and bone transplantation for joint reconstruction.

Advantages of bone grafting

  • Restoration of joint stability
  • Improvement of shoulder function
  • Pain relief and prevention of further dislocations
  • Protection against progressive joint damage

Advantages of these methods compared to joint replacement

Biological reconstructions are increasingly preferred as they preserve the natural joint and can delay the need for an artificial joint replacement.

Important advantages of cartilage and bone transplants over joint replacements

  • Preservation of the natural anatomy - Unlike joint replacement, these methods preserve the natural shoulder structure.
  • Long-term functionality - restoration of normal joint movement and resilience.
  • Reduced risk of complications - No risks such as implant wear, loosening or revision surgery.

Who is a suitable candidate for cartilage and bone transplants?

These procedures are particularly suitable for:

  • Patients with localized cartilage or bone defects due to injuries or degenerative diseases.
  • Patients with chronic shoulder instability and bone defects.
  • Active people who prefer to maintain their joint.
  • Patients who are unsuitable for a joint replacement (e.g. due to their age or other health factors).
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Success rates and case studies

Scientific studies show high success rates for cartilage and bone transplants. Patients report significant pain relief, improved joint stability and a high rate of return to activity.

Case study: Young athlete with cartilage damage

A 30-year-old patient with a cartilage defect in his shoulder was treated using osteochondral allograft transplantation. After six months, he achieved full mobility and returned to competitive sport.

Case study: Recurrent shoulder dislocations

A 45-year-old patient with chronic shoulder instability due to glenoid bone atrophy was treated with the Latarjet method. Two years after the operation, he reported stable shoulder function without recurrent dislocations.

Frequently asked questions

Full recovery can take up to 6 months, depending on the extent of the procedure and the rehabilitation strategy.

Discomfort can occur after the operation, but this can be treated well with modern pain therapy and physiotherapy.

Success rates are 80-90%, with significant improvement in joint function and pain reduction.

If cartilage and bone damage is very severe, a joint replacement may be the better long-term solution.

Conclusion

Cartilage and bone grafts are innovative solutions for patients with shoulder pain and instability. These procedures help to restore function, relieve pain and delay the need for joint replacement.

If you suffer from persistent shoulder problems, consult a specialist to find the best treatment option for you.

Do not hesitate to contact me for further information or a consultation!

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My ordination in 1190 Vienna
My ordination in 1110 Vienna
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