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Osseous Defects Seen in Patients with Anterior Shoulder Instability

Shoulder surgeons need to be aware of the critical size of the glenoid or humeral osseous defects seen in patients with anterior shoulder instability, since the considerable size of osseous defect is reported to cause postoperative instability. Biomechanical studies have identified the size of the o...

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Autores principales: Yamamoto, Nobuyuki, Itoi, Eiji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667108/
https://www.ncbi.nlm.nih.gov/pubmed/26640623
http://dx.doi.org/10.4055/cios.2015.7.4.425
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author Yamamoto, Nobuyuki
Itoi, Eiji
author_facet Yamamoto, Nobuyuki
Itoi, Eiji
author_sort Yamamoto, Nobuyuki
collection PubMed
description Shoulder surgeons need to be aware of the critical size of the glenoid or humeral osseous defects seen in patients with anterior shoulder instability, since the considerable size of osseous defect is reported to cause postoperative instability. Biomechanical studies have identified the size of the osseous defect which affects stability. Since engagement always occurs between a Hill-Sachs lesion and the glenoid rim, when considering the critical size of the Hill-Sachs lesion, we have to simultaneously consider the size of the glenoid osseous defect. With the newly developed concept of the glenoid track, we are able to evaluate whether a large Hill-Sachs lesion is an "on-track" or "off-track" lesion, and to consider both osseous defects together. In case of an off-track Hill-Sachs lesion, if the glenoid defect is less than 25%, no treatment is required. In this case, the Latarjet procedure or arthroscopic remplissage procedure can be a treatment option. However, if the glenoid defect is more than 25%, treatment such as bone grafting is required. This will convert an off-track lesion to an on-track lesion. After the bone graft or Latarjet procedure, if the Hill-Sachs lesion persists as off-track, then further treatment is necessitated. In case with an on-track Hill-Sachs lesion and a less than 25% glenoid defect, arthroscopic Bankart repair alone is enough.
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spelling pubmed-46671082015-12-04 Osseous Defects Seen in Patients with Anterior Shoulder Instability Yamamoto, Nobuyuki Itoi, Eiji Clin Orthop Surg Review Article Shoulder surgeons need to be aware of the critical size of the glenoid or humeral osseous defects seen in patients with anterior shoulder instability, since the considerable size of osseous defect is reported to cause postoperative instability. Biomechanical studies have identified the size of the osseous defect which affects stability. Since engagement always occurs between a Hill-Sachs lesion and the glenoid rim, when considering the critical size of the Hill-Sachs lesion, we have to simultaneously consider the size of the glenoid osseous defect. With the newly developed concept of the glenoid track, we are able to evaluate whether a large Hill-Sachs lesion is an "on-track" or "off-track" lesion, and to consider both osseous defects together. In case of an off-track Hill-Sachs lesion, if the glenoid defect is less than 25%, no treatment is required. In this case, the Latarjet procedure or arthroscopic remplissage procedure can be a treatment option. However, if the glenoid defect is more than 25%, treatment such as bone grafting is required. This will convert an off-track lesion to an on-track lesion. After the bone graft or Latarjet procedure, if the Hill-Sachs lesion persists as off-track, then further treatment is necessitated. In case with an on-track Hill-Sachs lesion and a less than 25% glenoid defect, arthroscopic Bankart repair alone is enough. The Korean Orthopaedic Association 2015-12 2015-11-13 /pmc/articles/PMC4667108/ /pubmed/26640623 http://dx.doi.org/10.4055/cios.2015.7.4.425 Text en Copyright © 2015 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Yamamoto, Nobuyuki
Itoi, Eiji
Osseous Defects Seen in Patients with Anterior Shoulder Instability
title Osseous Defects Seen in Patients with Anterior Shoulder Instability
title_full Osseous Defects Seen in Patients with Anterior Shoulder Instability
title_fullStr Osseous Defects Seen in Patients with Anterior Shoulder Instability
title_full_unstemmed Osseous Defects Seen in Patients with Anterior Shoulder Instability
title_short Osseous Defects Seen in Patients with Anterior Shoulder Instability
title_sort osseous defects seen in patients with anterior shoulder instability
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667108/
https://www.ncbi.nlm.nih.gov/pubmed/26640623
http://dx.doi.org/10.4055/cios.2015.7.4.425
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