Chronic Glenohumeral Dislocation

Sahajpal, Deenesh T.; Zuckerman, Joseph D.

doi:10.5435/00124635-200807000-00004

Cited by 29 publications

(26 citation statements)

References 17 publications

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“…The reported outcomes of arthroscopic remplissage are promising. Purchase, Sahajpal et al [80] reported a recurrent instability rate of 7% at 2 years post surgery with no significant loss in range of motion. Other studies report a loss of external rotation between 1.9 to 8 degrees [81,82] .…”

Section: %-40% Bone Lossmentioning

confidence: 99%

“…Open techniques involve mobilizing the tendon free from its attachment on the greater tuberosity and suturing it into the defect over the lateral humeral cortex. In larger defects up to 40% it is advisable to osteotomise the greater tuberosity with the infraspinatus tendon and to fix the bone and tendon transfer into the defect with fully threaded cancellous screws [80] . The reported outcomes of arthroscopic remplissage are promising.…”

Section: %-40% Bone Lossmentioning

confidence: 99%

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

Ramhamadany

Modi

2016

WJO

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The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures.

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Section: %-40% Bone Lossmentioning

confidence: 99%

Section: %-40% Bone Lossmentioning

confidence: 99%

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

Ramhamadany

Modi

2016

WJO

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“…Little has been published in the literature with regard to indications and outcomes of this technique, but it has been suggested that disimpaction grafting is the best indicated for defects that are less than 3 to 4 weeks old and involve <40% of the articular surface. Performing this procedure in younger patients with adequate bone stock to support the articular repair can also increase the success rate [33]. …”

Section: Treatmentmentioning

confidence: 99%

Management of Humeral and Glenoid Bone Loss in Recurrent Glenohumeral Instability

Mascarenhas

Rusen

Saltzman

et al. 2014

Advances in Orthopedics

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Recurrent shoulder instability and resultant glenoid and humeral head bone loss are not infrequently encountered in the population today, specifically in young, athletic patients. This review on the management of bone loss in recurrent glenohumeral instability discusses the relevant shoulder anatomy that provides stability to the shoulder joint, relevant history and physical examination findings pertinent to recurrent shoulder instability, and the proper radiological imaging choices in its workup. Operative treatments that can be used to treat both glenoid and humeral head bone loss are outlined. These include coracoid transfer procedures and allograft/autograft reconstruction at the glenoid, as well as humeral head disimpaction/humeroplasty, remplissage, humeral osseous allograft reconstruction, rotational osteotomy, partial humeral head arthroplasty, and hemiarthroplasty on the humeral side. Clinical outcomes studies reporting general results of these techniques are highlighted.

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“…Fixation devices may be used to secure the graft; however, it is unclear to what extent this is necessary. 9 In theory, the addition of a cartilaginous interface with restoration of normal anatomy for articulation with the glenoid may prevent future lesion engagement and subsequent instability. Because humeral head osteochondral allograft transplantation has only recently been introduced, the outcomes of the procedure are poorly understood.…”

mentioning

confidence: 99%