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Evaluation of Bone Loss and the Glenoid Track

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Elite Techniques in Shoulder Arthroscopy

Abstract

Glenohumeral bone loss (e.g., bony Bankart and Hill-Sachs lesions) is a common sequela of shoulder dislocation and is frequently implicated in recurrent instability. Performing surgical repair of soft tissue structures without addressing glenohumeral bone deficiency may predispose patients to repeated instability. Accurate diagnosis and quantification of glenohumeral bone loss is critical to guide surgical management of these lesions.

In this chapter, we first describe the anatomic and biomechanical basis of shoulder stability and how disruption of normal shoulder anatomy, either from soft tissue injury or glenohumeral bone deficiency, can lead to recurrent instability. We next discuss the epidemiology and types of glenoid and humeral head lesions. An emerging concept in humeral bone loss is the notion of “engaging Hill-Sachs lesions,” and we present the techniques described that may help predict which Hill-Sachs lesions engage with the glenoid rim and must be surgically addressed. We conclude with a description of how glenohumeral deficiency can be identified and quantified on arthroscopy as well as on imaging studies, including X-rays, computed tomography, and magnetic resonance imaging.

The authors have no financial disclosures.

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Author information

Authors and Affiliations

  1. Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Nancy A. Chauvin MD

  2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Nancy A. Chauvin MD

  3. Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Vishal Saxena MD

  4. Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA

    Stuart D. Kinsella MD, MTR

  5. Department of Radiology and Biomedical Imaging, University of Virginia, Hampton, VA, USA

    Jose M. Morey MD

  6. Department of Internal Medicine, Eastern Virginia Medical School, Hampton, VA, USA

    Jose M. Morey MD

  7. Department of Radiology, Hampton VA Medical Center, Hampton, VA, USA

    Jose M. Morey MD

  8. Almaden Research Lab, IBM Watson, Hampton, VA, USA

    Jose M. Morey MD

Authors
  1. Nancy A. Chauvin MD
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  2. Vishal Saxena MD
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  3. Stuart D. Kinsella MD, MTR
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  4. Jose M. Morey MD
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Corresponding author

Correspondence to Nancy A. Chauvin MD .

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Editors and Affiliations

  1. Department of Orthopedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    John D. Kelly IV

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Chauvin, N.A., Saxena, V., Kinsella, S.D., Morey, J.M. (2016). Evaluation of Bone Loss and the Glenoid Track. In: Kelly IV, J. (eds) Elite Techniques in Shoulder Arthroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-25103-5_6

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  • DOI: https://doi.org/10.1007/978-3-319-25103-5_6

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