Key result
Glenoid bone loss >20% or Hill-Sachs lesions >30% are indications for surgical interventions such as open bony procedures, arthroscopic remplissage, or open bone grafting.
Outlines indications for surgical management of glenoid and humeral bone loss in shoulder instability.
May inform surgical thresholds in shoulder instability; leaves open prospective validation of these cutoffs.
Glenoid and humeral head bone deficiency is a common reason for recurrent anterior shoulder instability and failure of capsulolabral reconstruction. There is a strong association between the severity of the bone defects and the number and ease of recurrent instability. Clinical evaluation, advanced imaging, examination under anesthesia, and diagnostic arthroscopy are important in decision making. Glenoid bone loss greater than 20%, an engaging Hill-Sachs lesion, or Instability Severity Index Score greater than 6 are indications for an open bony procedure to restore the glenoid articular arc. Hill-Sachs lesions greater than 30% should be directly addressed with either an arthroscopic remplissage technique or open bone grafting procedure.
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Bollier et al. (2010) conducted a review in Glenoid and humeral head bone deficiency with recurrent anterior shoulder instability. Open bony procedure, arthroscopic remplissage, or open bone grafting was evaluated. Glenoid bone loss >20% or Hill-Sachs lesions >30% are indications for surgical interventions such as open bony procedures, arthroscopic remplissage, or open bone grafting.
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