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Innovative Approaches in the Management of Shoulder Instability: Current Concept Review

  • Outcomes Research in Orthopedics (O Ayeni, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

This article summarises the latest innovations and concepts in the management of shoulder instability associated with glenoid bone loss.

Recent Findings

The management of shoulder instability has undergone significant evolution in the last century with rapid strides being made in the last few decades due to the transition from open to arthroscopic techniques allowing management of pathological entities which were previously untreatable. However, there is no consensus on treatment methods, especially in the presence of glenoid bone loss. The complication profile associated with non-anatomic glenoid bony reconstruction procedures has triggered research for alternate techniques using free bone grafts. Open Latarjet procedure continues to be the gold standard in the face of glenoid bone loss; however, arthroscopic anatomic glenoid reconstruction with bone block grafts is gaining in popularity and is associated with excellent short-term clinico-radiologic outcomes.

Summary

Arthroscopic anatomic glenoid reconstruction using bone grafts has been proposed as an alternative to the complex all-arthroscopic Latarjet procedure with excellent short-term results, minimal complications and a relatively easier learning curve. Capsular reconstruction has emerged as option for the management of instability with poor quality or absent capsular tissue. Future long-term outcome studies and randomised comparative trials will determine if these innovations stand the test of time.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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  1. Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, 5955 Veterans’ Memorial Lane, Halifax, NS, B3H 2E1, Canada

    Rakesh John & Ivan Wong

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John, R., Wong, I. Innovative Approaches in the Management of Shoulder Instability: Current Concept Review. Curr Rev Musculoskelet Med 12, 386–396 (2019). https://doi.org/10.1007/s12178-019-09569-z

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