Bone-mediated anteroinferior glenohumeral instability : Current concepts

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Recurrent anterior shoulder instability frequently involves anterior glenoid rim defects.
• Significant bone loss compromises glenohumeral stability, necessitating bony augmentation.

Purpose of the Study:

• To compare the Latarjet technique and free bone grafting for managing substantial anterior glenoid bone defects.
• To evaluate the biomechanical and clinical outcomes of these reconstructive procedures.

Main Methods:

• Review of existing literature on Latarjet and free bone grafting for anterior glenoid defects.
• Analysis of biomechanical principles and clinical results for both techniques.
• Consideration of patient-specific factors and defect characteristics.

Main Results:

• The Latarjet technique provides biomechanically superior stabilization but is extra-anatomical with a higher complication rate.
• Free bone grafting allows anatomical reconstruction with unlimited graft size and generally fewer complications.
• Both open and arthroscopic approaches yield good results for both procedures.

Conclusions:

• Treatment choice depends on defect type, glenoid track concept, and patient characteristics.
• Both Latarjet and free bone grafting are viable options for bony augmentation in anterior shoulder instability.
• Surgical approach selection should be based on surgeon expertise and patient factors.