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Management of Bone Loss in Posterior Glenohumeral Shoulder Instability: Current Concepts
Edward J Testa1, Jelle P van der List2, Brian R Waterman2
1Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island.
Abstract:
» Posterior glenohumeral instability is relatively uncommon compared with anterior instability, but is becoming an increasingly recognized and surgically managed shoulder pathology.» Soft-tissue stabilization alone may not be sufficient in patients who present with substantial bone loss to the posterior glenoid and/or the anterior humeral head.» For posterior glenoid defects, posterior glenoid osteoarticular augmentation can be used, and posterior glenoid opening wedge osteotomy can be considered in cases of posterior instability with pathologic retroversion.» For humeral head lesions, several surgical treatment options are available including subscapularis transposition into the humeral head defect, autograft or allograft reconstruction, humeral rotation osteotomy, and shoulder arthroplasty.
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