Skip to main content

Shoulder Instability: Glenoid and Humeral-Head Bone Defect

  • Chapter
Shoulder Instability

Abstract

Glenohumeral bone loss is one of the most important factors responsible for failure and recurrence after a shoulder arthroscopic instability repair. A high percentage of patients with traumatic, recurrent anterior instability have some level of glenohumeral bone loss. It is necessary to recognize the amount of bone loss preoperatively in order to determine successful management strategies. Standard radiographs may be inadequate for detecting the extent of glenoid and humeral-head bone loss.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rowe CR (1961) Factors related to recurrences of anterior dislocation of the shoulder. Clin Orthop 20:40–48

    PubMed  CAS  Google Scholar 

  2. Burkhart SS De Beer JF (2002) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 16:677–694

    Article  Google Scholar 

  3. Tauber M, Resch H (2004) Reason for failure after surgical repair of anterior shoulder instability. J Shoulder Elbow Surg 13:279–285

    Article  PubMed  Google Scholar 

  4. Lim CT Rhee YG SECEC (2003) Abstract Book Oral 7: shoulder instability, pp 119

    Google Scholar 

  5. Bigliani LU, Newton PM, Steinmann SP et al (1998) Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med 26:41–45

    PubMed  CAS  Google Scholar 

  6. Edwards TB, Boulahia A, Walch G (2003) Radiographic analysis of bone defects in chronic anterior shoulder instability. Arthroscopy 19:732–739

    Article  PubMed  Google Scholar 

  7. Griffith JF, Antonio GE, Tong CW, Ming CK (2003) Anterior shoulder dislocation: quantification of glenoid bone loss with CT. AJR Am J Roentgenol 180:1423–1430

    PubMed  Google Scholar 

  8. Sugaya H, Moriishi J, Dohi M (2003) Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 85:878–884

    PubMed  Google Scholar 

  9. Itoi E, Lee SB, Berglund LJ et al (2000) The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 82:35–46

    PubMed  CAS  Google Scholar 

  10. Itoi E, Lee SB, Amrami KK et al (2003) Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography. Am J Sports Med 31:112–118

    PubMed  Google Scholar 

  11. Burkhart SS De Beer JF (2002) Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 18:488–491

    Article  PubMed  Google Scholar 

  12. Burkhart SS, Lo IK (2004) The inverted pear glenoid: an indicator of significant glenoid bone loss. Arthroscopy 20:169–174

    Article  PubMed  Google Scholar 

  13. Huijsmans PE, Haen PS, Kidd M et al (2007) Quantification of a glenoid defect with three-dimensional computed tomography and magnetic resonance imaging: a cadaveric study. J Shoulder Elbow Surg 16:803–809

    Article  PubMed  Google Scholar 

  14. Griffith JF, Antonio GE, Tong CW, Ming CK (2003) Anterior shoulder dislocation: quantification of glenoid bone loss with CT. AJR Am J Roentgenol 180:1423–1430

    PubMed  Google Scholar 

  15. Itoi E, Lee SB, Amrami KK et al (2003) Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography. Am J Sports Med 31:112–118

    PubMed  Google Scholar 

  16. Sugaya H, Moriishi J, Dohi M et al (2003) Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 85:878–884

    PubMed  Google Scholar 

  17. Pavlov H, Warren RF, Weiss CB Jr (1985) The roentgenographic evaluation of anterior shoulder instability. Clin Orthop Rel Res 194:153–158

    Google Scholar 

  18. De Wilde LF, Berghs BM, Audenaert E et al (2004) About the variability of the shape of the glenoid cavity. Surg Radiol Anat 26:54–59

    Article  PubMed  Google Scholar 

  19. Huysmans PE, Haen PS, Kidd M et al (2006) The shape of the inferior part of the glenoid: a cadaveric study. J Shoulder Elbow Surg 15:759–763

    Article  PubMed  Google Scholar 

  20. Kralinger F, Aigner F, Longato S et al (2006) Is the bare spot a consistent landmark for shoulder arthroscopy? A study of 20 embalmed glenoids with 3-dimensional computed tomographic reconstruction. Arthroscopy 22:428–432

    Google Scholar 

  21. Aigner F, Longato S, Fritsch H, Kralinger F (2004) Anatomical considerations regarding the “bare spot” of the glenoid cavity. Surg Radiol Anat 26:308–311

    Article  PubMed  CAS  Google Scholar 

  22. Provencher MT, Detterline AJ, Ghodadra N et al (2008) Measurement of glenoid bone loss: a comparison of measurement error between 45 degrees and 0 degrees bone loss models and with different posterior arthroscopy portal locations. Am J Sports Med 36:1132–1138

    Article  PubMed  Google Scholar 

  23. Willemsen UF, Wiedemann E, Brunner U et al (1998) Prospective evaluation of MR arthrography performed with high-volume intraarticular saline enhancement in patients with recurrent anterior dislocations of the shoulder. AJR Am J Roentgenol 170:79–84

    PubMed  CAS  Google Scholar 

  24. Stoller D, Shellock FG, Crues JV (1996) MRI of the shoulder: a rational approach to the reporting of findings. J Magn Reson Imaging 6:268–270

    Article  PubMed  Google Scholar 

  25. Barchilon VS, Kotz E, Barchilon Ben-Av M et al (2008) A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint. Skeletal Radiol 37:731–736

    Article  PubMed  Google Scholar 

  26. Chuang TY, Adams CR, Burkhart SS (2008) Use of preoperative threedimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 24:376–382

    Article  PubMed  Google Scholar 

  27. Saito H, Itoi E, Sugaya H et al (2005) Location of the glenoid defect in shoulders with recurrent anterior dislocation. Am J Sports Med 33:889–893

    Article  PubMed  Google Scholar 

  28. Stevens KJ, Preston BJ, Wallace WA, Kerslake RW (1999) CT and 3D reconstructions of shoulders with anterior glenohumeral instability. Clin Anat 12:326–336

    Article  PubMed  CAS  Google Scholar 

  29. Diederichs G, Seim H, Meyer H et al (2008) CT-based patient-specific modeling of glenoid rim defects: a feasibility study. AJR Am J Roentgenol 191:1406–1411

    Article  PubMed  Google Scholar 

  30. Griffith JF, Antonio GE, Yung PS et al (2008) Prevalence, pattern, and spectrum of glenoid bone loss in anterior shoulder dislocation: CT analysis of 218 patients. AJR Am J Roentgenol 190:1247–1254

    Article  PubMed  Google Scholar 

  31. Griffith JF, Yung PS, Antonio GE (2007) CT compared with arthroscopy in quantifying glenoid bone loss. AJR Am J Roentgenol 189:1490–1493

    Article  PubMed  Google Scholar 

  32. Jeske HC, Oberthaler M, Klingensmith M et al (2009) Normal glenoid rim anatomy and the reliability of shoulder instability measurements based on intrasite correlation. Surg Radiol Anat 31:623–625

    Article  PubMed  Google Scholar 

  33. Baudi P, Righi P, Bolognesi D et al (2005) How to identify and calculate glenoid bone deficit. Chir Organi Mov 90:145–152

    PubMed  CAS  Google Scholar 

  34. Baudi P (2008) Instructional Course of ESSKA Upper Extremity Committee: how to manage bone defects in shoulder instability. In: 13th ESSKA 2000 Congress, 2008 Porto/Portugal

    Google Scholar 

  35. Magarelli N, Milano G, Sergio P et al (2009) Intra-observer and interobserver reliability of the ‘Pico’ computed tomography method for quantification of glenoid bone defect in anterior shoulder instability. Skeletal Radiol 38:1071–1075

    Article  PubMed  Google Scholar 

  36. Calandra JJ, Baker CL, Uribe J (1989) The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations. Arthroscopy 5:254–247

    Article  PubMed  CAS  Google Scholar 

  37. Burkhart SS, Danaceau SM (2000) Articular length mismatch as a cause of failed Bankart repair. Arthroscopy 16:740–744

    Article  PubMed  CAS  Google Scholar 

  38. Rozing PM, de Bakker HM, Obermann WR (1986) Radiographic views in recurrent anterior shoulder dislocation. Comparison of six methods for identification of typical lesions. Acta Orthop Scand 57:328–330

    CAS  Google Scholar 

  39. Workman TL, Burkhard TK, Resnick D et al. (1992) Hill-Sachs lesion: comparison of detection with MR imaging, radiography, and arthroscopy. Radiology 185:847–852

    PubMed  CAS  Google Scholar 

  40. Rowe CR, Zarins B, Ciullo, JV (1984) Recurrent anterior dislocation of the shoulder after surgical repair. Apparent causes of failure and treatment. J Bone Joint Surg Am 66: 159–168

    PubMed  CAS  Google Scholar 

  41. Hardy P (2003) Bony lesions influence on the result of the arthroscopic treatment of gleno-humeral instability. Symposium: Shoulder instability-limits of arthroscopic surgery: bone deficiency, shrinkage, acute instability. In: 5th International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress. Auckland

    Google Scholar 

  42. Yamamoto N, Itoi E, Abe H et al (2007) Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track. J Shoulder Elbow Surg 16:649–656

    Article  PubMed  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Italia

About this chapter

Cite this chapter

Baudi, P., Righi, P., Urtoler, E.R., Milano, G. (2011). Shoulder Instability: Glenoid and Humeral-Head Bone Defect. In: Di Giacomo, G., Costantini, A., De Vita, A., de Gasperis, N. (eds) Shoulder Instability. Springer, Milano. https://doi.org/10.1007/978-88-470-2035-1_2

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2035-1_2

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2034-4

  • Online ISBN: 978-88-470-2035-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics