Nathan Olszewski1, Michael Gustin1, Emily J Curry1, Xinning Li2. 1. Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA, 02118, USA. 2. Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA, 02118, USA. xinning.li@gmail.com.
Abstract
PURPOSE OF THE REVIEW: The goal of this review is to provide a guide on surgical decision-making options for complex anterior shoulder instability using a case-based approach. RECENT FINDINGS: Arthroscopic Bankart repair is well documented for having successful outcomes in patients with isolated labral tear involvement with minimal bone loss. Latarjet is a generally accepted procedure in patients with 20-30% glenoid bone loss. When bone loss exceeds that which cannot be managed through Latarjet, a range of options exist and are highly dependent upon the extent of osseous deficiency on both the glenoid and humeral sides, surgeon experience, and patient-specific factors. The use of reverse total shoulder arthroplasty for the management of chronic locked shoulder dislocations has been described as a successful management option. Treatment options for complex anterior shoulder instability range widely based on patients' presenting exam, surgical history, amount of glenoid bone loss, size of Hill-Sachs lesion, and surgeon preference. When selecting the appropriate surgical intervention, the treating surgeon must consider the patient history, physical exam, and preoperative imaging along with patient expectations.
PURPOSE OF THE REVIEW: The goal of this review is to provide a guide on surgical decision-making options for complex anterior shoulder instability using a case-based approach. RECENT FINDINGS: Arthroscopic Bankart repair is well documented for having successful outcomes in patients with isolated labral tear involvement with minimal bone loss. Latarjet is a generally accepted procedure in patients with 20-30% glenoid bone loss. When bone loss exceeds that which cannot be managed through Latarjet, a range of options exist and are highly dependent upon the extent of osseous deficiency on both the glenoid and humeral sides, surgeon experience, and patient-specific factors. The use of reverse total shoulder arthroplasty for the management of chronic locked shoulder dislocations has been described as a successful management option. Treatment options for complex anterior shoulder instability range widely based on patients' presenting exam, surgical history, amount of glenoid bone loss, size of Hill-Sachs lesion, and surgeon preference. When selecting the appropriate surgical intervention, the treating surgeon must consider the patient history, physical exam, and preoperative imaging along with patient expectations.
Entities:
Keywords:
Anterior shoulder instability; Bankart repair; Critical Glenoid Bone Loss; Eden-Hybinette procedure; Latarjet procedure; Pectoralis major transfer; Remplissage; Reverse total shoulder arthroplasty
Authors: Brian R Neri; David V Tuckman; Jonathan T Bravman; Duke Yim; Deenesh T Sahajpal; Andrew S Rokito Journal: J Shoulder Elbow Surg Date: 2007-05-24 Impact factor: 3.019
Authors: Brent B Wiesel; Gary M Gartsman; Cyrus M Press; Edwin E Spencer; Brent J Morris; Joseph Zuckerman; Reza Roghani; Gerald R Williams Journal: J Bone Joint Surg Am Date: 2013-11-20 Impact factor: 5.284