Arthroscopic Stabilization in Patients with an Inverted Pear Glenoid

Abstract

Arthroscopic stabilization for recurrent instability, even in the presence of a significant bony defect of the glenoid, can yield a stable shoulder; however, outcomes are not as predictable especially in attritional bone loss cases. Longer-term follow-up is needed to see if these results hold up over time.

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

“…However in patients with excessive joint laxity, arthroscopic stabilization is unreliable with a recurrent instability rate of 23%. These findings are also supported by a study of 21 patients with 20%-30% bone loss by Mologne et al [75] . One must be cautious with these findings, however, as both studies are poorly powered statistically with limited follow-up duration.…”

Comparisons of glenoid bony defects between normal cadaveric specimens and patients with recurrent shoulder dislocation: an anatomic study

“…dislocation, 4,5,12,17,22 how much bone loss can be tolerated by the surgeon when treating glenoid insufficiency and the best method of measuring that bone loss accurately remains controversial. The first goal of this study was to define the size, location, and the amount of the bone loss seen in the glenoids of 24 patients with recurrent anterior shoulder dislocation who were studied with 3-dimensional computed tomography (3D CT) scanning compared with normal cadaveric specimens.…”

The intra- and inter-observer reliability of the CT-scan based X index to quantify glenoid bone loss in chronic anterior shoulder instability and its impact on decision making

“…Sixty patients with X index C 0.4 were included. The mean age was 28 years (average [15][16][17][18][19][20][21][22][23][24][25][26]. There were 56 men and 4 women, with 40 right and 20 left shoulders.…”

“…Multiple publications have demonstrated the importance of the failure of arthroscopic stabilization if associated with glenoid bone loss [7,9,10,16,19,21,23,25,30]. This therefore leads us to more efficiently analyze glenoid bony lesions in order to reduce recurrence.…”

“…Antero-inferior glenoid bone loss has been associated with higher rates of failure of arthroscopic technique [7,9,15,16,19,21,23,25,30]. Burkhart et al [11] previously reported that failure rate was higher than 50 % in patients with 25 % glenoid bony loss.…”