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Osteochondral Allograft Augmentation of the Glenoid for Instability with Bone Deficiency

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Surgery of Shoulder Instability

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Abstract

Glenoid bone defects in the setting of recurrent anterior shoulder instability can be difficult to treat. An intact glenoid articular arc is crucial for a stable articulation with the humeral head, and loss of articular congruency can prove detrimental in recurrent anterior shoulder instability. The size of the defect, coupled with patient-specific factors such as activity level, are major factors in determining appropriate treatment options. In general, defects <15 % of the glenoid width can be treated with soft tissue stabilization alone while defects >30 % of the glenoid width often require autograft or allograft glenoid augmentation. Defects between 15–30 % are in an indeterminate zone, and attention must be paid to the size of the defect and the demands of the patients. In general, patients in this group can be treated with direct fragment repair either through open or arthroscopic techniques as well as glenoid bone autograft or allograft augmentation. With appropriate patient selection criteria and sound surgical technique, the majority of patients with recurrent anterior shoulder instability associated with a glenoid osseous defect can be effectively treated and returned to a high level of function without recurrent instability.

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Author information

Authors and Affiliations

  1. Section of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Suite 300, Chicago, IL, 60612, USA

    Rachel M. Frank, John McNeil, Michael Hellman & Anthony A. Romeo

  2. Surgery and Orthopaedics, USUHS, Orthopaedic Shoulder, Knee and Sports Surgery, Department of Orthopaedic Surgery, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste 112, San Diego, CA, 92134, USA

    CDR Matthew T. Provencher

Authors
  1. Rachel M. Frank
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  2. John McNeil
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  3. Michael Hellman
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  4. Anthony A. Romeo
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  5. CDR Matthew T. Provencher
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Corresponding author

Correspondence to CDR Matthew T. Provencher .

Editor information

Editors and Affiliations

  1. School of Medicine, Department of Orthopedic Surgery, University of Virginia, Ray C. Hunt Drive 400, Charlottesville, 22908, Virginia, USA

    Stephen F. Brockmeier

  2. University of Virginia, Ray C. Hunt Drive 400, Charlottesville, 22903, Virginia, USA

    Mark D. Miller

  3. de Diagnóstico y Tratamiento, Department of Orthopaedic Surgery, Instituto Argentino, Marcelo T. de Alvear 2400, Buenos Aires, 1122, Argentina

    Guillermo Arce

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Frank, R.M., McNeil, J., Hellman, M., Romeo, A.A., Provencher, C.M.T. (2013). Osteochondral Allograft Augmentation of the Glenoid for Instability with Bone Deficiency. In: Brockmeier, S., Miller, M., Arce, G. (eds) Surgery of Shoulder Instability. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38100-3_6

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  • DOI: https://doi.org/10.1007/978-3-642-38100-3_6

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38099-0

  • Online ISBN: 978-3-642-38100-3

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