scholarly journals Arthroscopic repair is sufficient for treating recurrent shoulder instability in patients with bipolar bone defects and minor glenoid bone loss

2021 ◽  
Vol 24 ◽  
pp. 5-8
Author(s):  
Andrew Chia Chen Chou ◽  
Benjamin Joseph Kang ◽  
Aaron Junjie Tan ◽  
Denny Tijauw Tjoen Lie
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Bone Defects ◽  
Arthroscopic Repair ◽  
Glenoid Bone Loss ◽  
Recurrent Shoulder Instability

Recurrent Shoulder Instability: Current Concepts for Evaluation and Management of Glenoid Bone Loss

2010 ◽  
Vol 92 (Suppl 2) ◽  
pp. 133-151 ◽  
Author(s):  
CDR Matthew T Provencher ◽  
Sanjeev Bhatia ◽  
Neil S Ghodadra ◽  
Robert C Grumet ◽  
Bernard R Bach ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Glenoid Bone Loss ◽  
Recurrent Shoulder Instability

scholarly journals Posterior Shoulder Instability with Glenoid Bone Loss: Morphology of Posterior Bone Defects

2017 ◽  
Vol 33 (6) ◽  
pp. e28
Author(s):  
Matthew Provencher ◽  
Brendin Beaulieu-Jones ◽  
Justin Arner ◽  
George Sanchez ◽  
Ashley Tisosky ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Bone Defects ◽  
Glenoid Bone Loss ◽  
Posterior Shoulder Instability ◽  
Posterior Shoulder

scholarly journals Evaluation and Management of Failed Shoulder Instability Surgery

2017 ◽  
Vol 11 (1) ◽  
pp. 897-908 ◽  
Author(s):  
António Cartucho ◽  
Nuno Moura ◽  
Marco Sarmento
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Shoulder Instability ◽  
Bone Defects ◽  
Glenoid Bone Loss ◽  
Rotator Cuff Tears ◽  
Bone Block ◽  
Salvage Procedure ◽  
Tissue Quality ◽  
Contact Sports

Background: Failed shoulder instability surgery is mostly considered to be the recurrence of shoulder dislocation but subluxation, painful or non-reliable shoulder are also reasons for patient dissatisfaction and should be considered in the notion. Methods: The authors performed a revision of the literature and online contents on evaluation and management of failed shoulder instability surgery. Results: When we look at the reasons for failure of shoulder instability surgery we point the finger at poor patient selection, technical error and an additional traumatic event. More than 80% of surgical failures, for shoulder instability, are associated with bone loss. Quantification of glenoid bone loss and investigation of an engaging Hill-Sachs lesion are determining facts. Adequate imaging studies are determinant to assess labrum and capsular lesions and to rule out associated pathology as rotator cuff tears. CT-scan is the method of choice to diagnose and quantify bone loss. Arthroscopic soft tissue procedures are indicated in patients with minimal bone loss and no contact sports. Open soft tissue procedures should be performed in patients with small bone defects, with hiperlaxity and practicing contact sports. Soft tissue techniques, as postero-inferior capsular plication and remplissage, may be used in patients with less than 25% of glenoid bone loss and Hill-Sachs lesions. Bone block procedures should be used for glenoid larger bone defects in the presence of an engaging Hill-Sachs lesion or in the presence of poor soft tissue quality. A tricortical iliac crest graft may be used as a primary procedure or as a salvage procedure after failure of a Bristow or a Latarjet procedure. Less frequently, the surgeon has to address the Hill-Sachs lesion. When a 30% loss of humeral head circumference is present a filling graft should be used. Conclusion: Reasons for failure are multifactorial. In order to address this entity, surgeons must correctly identify the causes and tailor the right solution.

scholarly journals Distal Tibial Allograft Glenoid Reconstruction for Recurrent Shoulder Instability: Clinical Outcomes and Complications

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0009 ◽  
Author(s):  
Anthony F. De Giacomo ◽  
Hithem Rahmi ◽  
Sevag Bastian ◽  
Christopher Klein ◽  
John Itamura
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Functional Outcomes ◽  
Glenoid Bone Loss ◽  
Dash Score ◽  
Recurrent Instability ◽  
Allograft Reconstruction ◽  
Recurrent Shoulder Instability ◽  
Outcome Scores

Objectives: Treatment options for recurrent shoulder instability, in the setting of significant glenoid bone loss, consists of several iterations of bone stabilization procedures. However, advanced arthritic changes with the Laterjet procedure and rapid resorption changes with the iliac crest bone graft reconstruction has led into the search for more optimal surgical reconstruction options. The purpose of this study is to evaluate the clinical and functional outcomes of patients with recurrent shoulder instability, with significant glenoid bone loss, treated with fresh distal tibial allograft reconstruction with regards to recurrence, revision surgery, and complications. Methods: At a single institution, all consecutive patients with recurrent shoulder instability and at least 15% anterior glenoid bone loss, undergoing distal tibial allograft reconstruction, between 2011 to 2016, were identified by diagnostic and procedural codes. All clinical notes, diagnostic imaging, and operative reports were reviewed in detail. From these sources, demographics, operative techniques, and radiographic parameters were collected and measured. Functional outcome scores were prospectively collected from patients. The primary outcome of the study was the Disability of Arm, Shoulder, Hand (DASH) score. The secondary outcomes of the study were the Visual Analog Scale (VAS) pain score, Single Assessment Numeric Evaluation (SANE) score, recurrent instability, revision surgery, and complications. Results: At 6 years, there were a total of 36 distal tibial allograft reconstructions performed in patients with recurrent shoulder instability in the setting of significant glenoid bone loss. Amongst this cohort, average age was 35 years old with 72% of patients being male. The dominant extremity was involved in 20 (56%) of patients and 24 (67%) of patients had previous surgery to address episodes of shoulder instability. Follow-up, for the entire cohort was on average 15.5 months. In comparison to preoperative range of motion, after surgery there was significantly less abduction (P=0.01). At final follow-up, patients undergoing distial tibial allograft reconstruction showed trend towards significant improvement in the DASH score (preoperative DASH=50.7, postoperative DASH=37.1, P=0.09). In like manner, there was significant improvement in both the VAS score (P=0.001) and the SANE score (P=0.002). There was no significant difference in functional outcome scores between those patients who had failed a previous surgery for instability. Recurrent instability, after distal tibial allograft reconstruction, occurred in 4 (11%) of patients and 8 (22%) of patients underwent an additional surgical procedure. Complications occurred in 31% of patients, with the most common complication being rupture of the subscapularis. Conclusion: This study provides functional outcomes in one of the largest consecutive cohort of patients undergoing distal tibial allograft reconstruction for recurrent shoulder instability due to significant glenoid bone loss. The study suggests that distal tibial allograft reconstruction may provide improved functional outcomes in patients with recurrent shoulder instability. After this procedure, 89% of patients did not experience any additional episodes of shoulder instability. Despite these encouraging results, complications are common after this procedure, with 31% of patients experiencing a complication. [Table: see text][Table: see text]

3-Dimensional Quantification Glenoid Bone Loss in Recurrent Shoulder Instability – Role in Establishing Parameters for Latarjet vs Bankart Procedure

2021 ◽  
Vol 30 (7) ◽  
pp. e435-e436
Author(s):  
Marine Launay ◽  
Muhammad Naghman Choudhry ◽  
Nicholas Green ◽  
Peter Pivonka ◽  
Kenneth Cutbush ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Glenoid Bone Loss ◽  
3 Dimensional ◽  
Bankart Procedure ◽  
Recurrent Shoulder Instability

scholarly journals Clinical Outcomes of Shoulder Stabilization in Females With Glenoid Bone Loss

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110075
Author(s):  
Rachel M. Frank ◽  
Hytham S. Salem ◽  
Catherine Richardson ◽  
Michael O’Brien ◽  
Jon M. Newgren ◽  
...  
Keyword(s):  
Bone Loss ◽  
Clinical Outcomes ◽  
Shoulder Instability ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Instability ◽  
Latarjet Procedure ◽  
Shoulder Stabilization ◽  
Simple Shoulder Test ◽  
Female Patients

Background: Nearly all studies describing shoulder stabilization focus on male patients. Little is known regarding the clinical outcomes of female patients undergoing shoulder stabilization, and even less is understood about females with glenoid bone loss. Purpose: To assess the clinical outcomes of female patients with recurrent anterior shoulder instability treated with the Latarjet procedure. Study Design: Case series; Level of evidence, 4. Methods: All cases of female patients who had recurrent anterior shoulder instability with ≥15% anterior glenoid bone loss and underwent the Latarjet procedure were analyzed. Patients were evaluated after a minimum 2-year postoperative period with scores of the American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and pain visual analog scale. Results: Of the 22 patients who met our criteria, 5 (22.7%) were lost to follow-up, leaving 17 (77.2%) available for follow-up with a mean ± SD age of 31.7 ± 12.9 years. Among these patients, 16 (94.1%) underwent 1.6 ± 0.73 ipsilateral shoulder operations (range, 1-3) before undergoing the Latarjet procedure. Preoperative indications for surgery included recurrent instability with bone loss in all cases. After a mean follow-up of 40.2 ± 22.9 months, patients experienced significant score improvements in the American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and pain visual analog scale ( P < .05 for all). There were 2 reoperations (11.8%). There were no cases of neurovascular injuries or other complications. Conclusion: Female patients with recurrent shoulder instability with glenoid bone loss can be successfully treated with the Latarjet procedure, with outcomes similar to those of male patients in the previously published literature. This information can be used to counsel female patients with recurrent instability with significant anterior glenoid bone loss.

scholarly journals Critical Glenoid Bone Loss in Posterior Shoulder Instability

2018 ◽  
Vol 34 (12) ◽  
pp. e2
Author(s):  
Christopher Nacca ◽  
Joseph Gil ◽  
Rohit Badida ◽  
Joseph Crisco ◽  
Brett Owens
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Glenoid Bone Loss ◽  
Posterior Shoulder Instability ◽  
Posterior Shoulder
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