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Glenoid bone loss

Xinning Li, Antonio Cusano, Josef Eichinger
Shoulder dislocations are a common injury, with anterior shoulder dislocation among male patients being the most common presentation. A patient with recurrent shoulder instability, anterior-superior escape, and chronic subscapularis tendon rupture following multiple shoulder stabilization surgeries presents the surgeon with a complex and challenging case. This report describes a 40-year-old man with an extensive left shoulder history that included a failed Latarjet procedure, an irreparable, chronic subscapularis tear with grade 4 Goutallier fatty infiltration, and associated anterior-superior escape...
October 13, 2016: Orthopedics
Rachel M Frank, Anthony A Romeo, Matthew T Provencher
Anterior glenoid bone loss is present in nearly all cases of recurrent anterior glenohumeral instability. Treating glenoid bone loss in the setting of recurrent instability is challenging, and often, soft tissue stabilization procedures in isolation are inadequate. The nonanatomic, incongruous joint resulting from most bony augmentation procedures has motivated investigators to find an alternative solution. Recently, the use of fresh distal tibia allograft has been reported as an anatomic, osteoarticular reconstructive option for restoring the glenoid arc and maintaining glenohumeral congruency...
October 13, 2016: Orthopedics
Jason T Hamamoto, Timothy Leroux, Jorge Chahla, Sanjeev Bhatia, John D Higgins, Anthony A Romeo, Adam B Yanke, Nikhil N Verma
The preoperative assessment of anterior glenoid bone loss is a critical step in surgical planning for patients with recurrent anterior glenohumeral instability. The structural integrity of the glenoid has been identified as one of the most important factors influencing the success of operative repair. The currently accepted gold standard for glenoid structural assessment among most orthopaedic surgeons is the use of 3-dimensional reconstructed computed tomography images with the humeral head digitally subtracted, yielding an en face sagittal oblique view of the glenoid...
August 2016: Arthroscopy Techniques
Chad M Fortun, Ivan Wong, Joseph P Burns
Failed arthroscopic soft-tissue stabilization and anterior glenoid bone loss have been shown to have high failure rates after standard arthroscopic stabilization techniques. For patients with recurrent glenohumeral instability, the Bristow-Latarjet procedure is currently the standard of care. It is predominantly performed through an open deltopectoral approach but has recently been described arthroscopically. Although providing excellent clinical outcomes, the Bristow-Latarjet procedure violates the subscapularis muscle, has a steep learning curve with a high complication rate, and permanently changes the anterior shoulder anatomy, making any future revision surgery more challenging...
August 2016: Arthroscopy Techniques
Ivan J Antosh, John M Tokish, Brett D Owens
CONTEXT: Posterior shoulder instability has become more frequently recognized and treated as a unique subset of shoulder instability, especially in the military. Posterior shoulder pathology may be more difficult to accurately diagnose than its anterior counterpart, and commonly, patients present with complaints of pain rather than instability. "Posterior instability" may encompass both dislocation and subluxation, and the most common presentation is recurrent posterior subluxation. Arthroscopic and open treatment techniques have improved as understanding of posterior shoulder instability has evolved...
October 3, 2016: Sports Health
Sang-Jin Shin, Bong Jae Jun, Young Won Koh, Michelle H McGarry, Thay Q Lee
PURPOSE: Estimation of anterior glenoid bone loss is important for surgical decision-making. The purpose of this study was to describe a method for estimating anterior glenoid bone loss. METHODS: Thirty-nine cadaveric glenoids were digitized to obtain glenoid geometry. Glenoid bare spot centre, arthroscopic centre, and centre of the inferior glenoid circle relative to the geometric centre were measured. To simulate anterior glenoid bone loss, imaginary sequential osteotomies were created 0°, 22...
September 26, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Amar Malhas, Abbas Rashid, Dave Copas, Steve Bale, Ian Trail
The management of glenoid bone loss is a major challenge in both complex primary and revision arthroplasty surgery. To deal with this problem, a number of techniques have been advocated, although there has been no previous systematic review of the literature. In the present review, we have attempted to identify a coherent strategy for addressing this problem, taking into account the degree of bone loss, the advantages and limits of standard implants, bone reconstruction techniques and the use of customized prostheses...
October 2016: Shoulder & Elbow
Nikhil N Verma
Bone reconstruction for management of glenohumeral instability to reduce postoperative recurrence rates is increasingly emphasized in our literature. Unfortunately, significant complication rates are associated with these procedures, particularly in the United States where training in bony glenoid reconstruction may be limited. The alternative of early intervention, specifically surgical treatment of first-time shoulder dislocation, could result in glenoid bone preservation and overall improvement in the results of soft-tissue stabilization procedures...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
P D Cowling, M A Akhtar, R Y L Liow
OBJECTIVES: A variety of operative techniques have been described as under the term 'Bristow-Latarjet' procedure. This review aims to define the original procedure, and compare the variation in techniques described in the literature, assessing any effect on clinical outcomes. MATERIALS AND METHODS: A systematic review of 24 studies was performed to compare specific steps of the technique (coracoid osteotomy site, subscapularis approach, orientation and position of coracoid graft fixation and fixation method, additional labral and capsular repair) and detect any effect this variability had on outcomes...
September 2016: Bone & Joint Journal
Santosh Venkatachalam, Phil Storey, Scott J Macinnes, Amjid Ali, David Potter
BACKGROUND: The purpose of the present study was to evaluate the results of the Sheffield bone block procedure for anteroinferior bone loss in traumatic shoulder instability. In this modified open technique, the medial half of coracoid process without its soft tissue attachments is used to provide congruent augmentation of the anteroinferior glenoid and secured with two screws. METHODS: In this retrospective consecutive case series (2007-11), all patients having recurrent traumatic instability with glenoid bone loss > 20% and/or a large Hill-Sachs lesion were included...
April 2016: Shoulder & Elbow
Philipp Moroder, Franziska Haniel, Michael Quirchmayr, Eva Schulz, Manfred Eppel, Nicholas Matis, Alexander Auffarth, Herbert Resch
BACKGROUND: Current glenoid defect measurement techniques only quantify bone loss in terms of defect diameter or surface. However, the glenoid depth plays an important role in shoulder stabilization by means of concavity compression. CASE PRESENTATION: We present a case of a professional wrestler who suffered from anterior shoulder instability after sustaining a bony Bankart lesion without loss of glenoid surface area but flattening of the concavity due to medialization of the fragment...
2016: BMC Musculoskeletal Disorders
Ramsey Chammaa, Ofir Uri, Simon Lambert
BACKGROUND: Total shoulder arthroplasty for end-stage glenohumeral arthritis with severe glenoid bone loss poses a unique challenge for shoulder surgeons. Current surgical solutions are limited and associated with high complication rates. We hypothesized that a custom-made computer-aided design-computer-aided manufacturing (CAD-CAM) total shoulder replacement (TSR; Stanmore Implants Worldwide, Elstree, UK) resembling a total hip prosthesis could offer a reliable alternative for this challenging subset of patients...
August 10, 2016: Journal of Shoulder and Elbow Surgery
Birgit S Werner, Ayman F Abdelkawi, Dorota Boehm, Robert Hudek, Piet Plumhoff, Klaus J Burkhart, Frank Gohlke
BACKGROUND: Revision of failed shoulder arthroplasty is often associated with poor results and a high rate of complications. Significant humeral bone loss after removal of long stems poses a considerable surgical challenge. Therefore, the aim of our study was the evaluation of the clinical and radiologic outcome of cemented long-stem humeral components in revision reverse shoulder arthroplasty with a minimum 5 years' follow-up. METHODS: Between June 2001 and June 2009, revision reverse shoulder arthroplasty using long-stem cemented humeral components was performed in 124 patients...
August 9, 2016: Journal of Shoulder and Elbow Surgery
Davide Blonna, Enrico Bellato, Francesco Caranzano, Marco Assom, Roberto Rossi, Filippo Castoldi
BACKGROUND: The arthroscopic Bankart repair and open Bristow-Latarjet procedure are the 2 most commonly used techniques to treat recurrent shoulder instability. PURPOSE: To compare in a case control-matched manner the 2 techniques, with particular emphasis on return to sport after surgery. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A study was conducted in 2 hospitals matching 60 patients with posttraumatic recurrent anterior shoulder instability with a minimum follow-up of 2 years (30 patients treated with arthroscopic Bankart procedure and 30 treated with open Bristow-Latarjet procedure)...
August 8, 2016: American Journal of Sports Medicine
Maurice Balke, Sven Shafizadeh, Bertil Bouillon, Marc Banerjee
INTRODUCTION: The aim of this study was to evaluate the current state of treatment in traumatic anterior shoulder dislocation in Germany and to detect changes over the last 12 years. METHODS: Seven hundred ninety-six trauma and/or orthopaedic departments were found in the German hospital directory 2012. The websites of each department were searched for the email address of the responsible shoulder surgeon (if applicable) or the head of the department. Seven hundred forty-six email addresses were found, and emails with the request to participate in an online survey were sent in January 2013...
August 8, 2016: Archives of Orthopaedic and Trauma Surgery
David M Burns, Jaskarndip Chahal, Shahram Shahrokhi, Patrick Henry, David Wasserstein, Cari Whyne, John Theodoropoulos, Darrell Ogilvie-Harris, Tim Dwyer
BACKGROUND: Anatomic studies have demonstrated that bipolar glenoid and humeral bone loss have a cumulative effect on shoulder instability and that these defects may engage in functional positions depending on their size and location, potentially resulting in failure of stabilization procedures. Determining which lesions pose a risk for engagement remains challenging, with arthroscopic assessments and a 3-dimensional computed tomography (CT)-based glenoid track method being accepted approaches at this time...
August 5, 2016: American Journal of Sports Medicine
Anna Maria Kubicka, Jakub Stefaniak, Przemysław Lubiatowski, Jan Długosz, Marcin Dzianach, Marcin Redman, Janusz Piontek, Leszek Romanowski
PURPOSE: The main purpose of this study is to establish which of two methods is more reliable in glenoid assessment for instability in pre-operative planning. Accordingly, we have studied the intra- and inter-observer reliability of glenoid parameters with the use of two-dimensional (2D) and three-dimensional (3D) reconstructed computed tomography (CT) images. METHODS: One hundred glenoids were measured with the use of 2D-CT and 3D-CT (in 3D orientation) by two independent observers (one experienced and one inexperienced)...
August 5, 2016: International Orthopaedics
Robert U Hartzler, Christopher N H Bui, Woong K Jeong, Masaki Akeda, Alex Peterson, Michelle McGarry, Patrick J Denard, Stephen S Burkhart, Thay Q Lee
PURPOSE: To validate the glenoid track concept in a cadaveric bipolar bone loss model and to test whether "on-track" and "off-track" lesions can be stabilized with Bankart repair (BR) with or without Hill-Sachs remplissage (HSR). METHODS: Eight fresh-frozen cadaveric shoulders were tested in a custom apparatus with passive axial rotation and then progressive translational loading (10 to 40 N) at mid-range (60°) and end-range external rotation (90°). Injury conditions included glenoid bone loss of 15% with on-track (15%) and off-track (30%) Hill-Sachs lesions...
July 15, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jennifer Kurowicki, Jacob J Triplet, Enesi Momoh, Molly A Moor, Jonathan C Levy
BACKGROUND: Locked anterior shoulder (LAS) with static instability and anterior glenoid bone loss is challenging in the elderly population. Reverse shoulder arthroplasty (RSA) has been employed in treating these patients. No study has compared RSA for LAS with classically indicated RSA. METHODS: A retrospective case-control study of patients treated with RSA for LAS with glenoid bone loss and static instability was performed using matched controls treated with primary RSA for classic indications...
July 12, 2016: Journal of Shoulder and Elbow Surgery
J Pogorzelski, K Beitzel, A B Imhoff, S Braun
OBJECTIVE: Shoulder stabilization. INDICATIONS: Symptomatic recurrent anterior shoulder instability combined with glenoid bone loss of approximately 20-35 % of the glenoid surface, engaging Hill-Sachs lesion and/or previously failed arthroscopic Bankart repair. In patients with a high risk of redislocation (contact sports) or irreparable soft tissue injury the Latarjet procedure can be considered as a first-line treatment. CONTRAINDICATIONS: Contraindicated if arthroscopic Bankart repair is possible...
July 12, 2016: Operative Orthopädie und Traumatologie
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