Chronic anterior shoulder instability with bone loss: a practical approach

Area of Science:

• Orthopedics
• Sports Medicine
• Surgical Innovation

Background:

• Glenohumeral joint stability depends on bone congruency and capsulolabral structures.
• Anterior shoulder instability frequently involves glenoid and humeral bone lesions.
• Isolated Bankart repair shows high failure rates when both bone lesions coexist.

Purpose of the Study:

• To review surgical techniques for chronic anterior shoulder instability.
• To highlight the role of the Latarjet procedure in cases with bone loss.
• To discuss factors influencing treatment decisions beyond bone loss.

Main Methods:

• Review of current literature on shoulder instability surgical management.
• Analysis of the Latarjet procedure's efficacy and indications.
• Exploration of alternative and emerging techniques like Remplissage and bone grafting.

Main Results:

• The Latarjet procedure is the gold standard for glenoid bone loss, offering reliable short- and long-term results.
• Emerging techniques like Remplissage address humeral defects, aiming for anatomical restoration.
• Treatment success is multifactorial, influenced by bone loss, patient laxity, and activity levels.

Conclusions:

• The Latarjet procedure remains a benchmark for chronic anterior shoulder instability with bone loss.
• Personalized treatment strategies considering patient-specific factors are crucial.
• Advancements focus on anatomical reconstruction for improved stability and function.