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Glenoid augmentation for subcritical bone loss: a narrative review
Daniel J Cognetti1, Mikalyn T DeFoor1, Robert U Hartzler2
1San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
Annals of Joint
|May 1, 2024
Summary
Optimal treatment for subcritical glenoid bone loss (GBL) in anterior shoulder instability remains unclear. Glenoid augmentation is increasingly considered for these cases, moving beyond isolated soft-tissue repairs.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanics
Background:
- Anterior shoulder instability is common in young, active individuals.
- Significant glenoid bone loss (GBL) (>25%) typically requires bone grafting.
- Optimal management for subcritical GBL (>13.5%) lacks consensus.
Purpose of the Study:
- Review the pathoanatomy of anterior shoulder instability and subcritical GBL.
- Highlight evidence for open augmentation procedures versus other treatments.
- Provide insights into managing subcritical GBL.
Main Methods:
- Narrative literature review.
- Focused on subcritical GBL in anterior glenoid stabilization.
- Included citation and reference list analysis.
Main Results:
- Computed tomography (CT) is standard for measuring subcritical GBL (<13.5%).
- Arthroscopic Bankart repair (ABR) is common, but isolated ABR may be insufficient for subcritical GBL.
- Glenoid augmentation and Latarjet procedures are gaining consideration.
Conclusions:
- No consensus exists for treating recurrent shoulder instability with subcritical GBL.
- Isolated ABR is likely inadequate for subcritical GBL.
- Glenoid bone augmentation is a growing area of interest for restoring stability.
