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Clin Shoulder Elbow > Volume 12(2); 2009 > Article
Journal of the Korean Shoulder and Elbow Society 2009;12(2):255-263.
DOI: https://doi.org/10.5397/CiSE.2009.12.2.255    Published online December 31, 2009.
Open Techniques for Bone Defect in Anterior Shoulder Instability
Bong Gun Lee, Yong Girl Rhee
Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea. shoulderrhee@hanmail.net
골 결손이 동반된 전방 견관절 불안정성에서 개방적 수술 술기
경희대학교 의과대학 정형외과학교실
An osseous defect in the glenoid and humeral head is closely associated with recurrence of anterior shoulder instability. The purpose of this article is to describe the open surgical techniques and introduce our experiences with anterior instability with a significant osseous defect. MATERIALS AND METHODS: We reviewed the articles that have focused on and/or mentioned the affect of osseous defects on anterior shoulder instability. The open surgical techniques and its related pearls are summarized in this review.
Accurate evaluation for the size and location of the osseous defect is critical for preventing recurrence after restoration of the anterior capsulolabral structure. The glenoid bone restoration techniques include the coracoids transfer (the Bristow procedure and the Latarjet procedure) and a structural iliac bone graft. Rotational humeral osteotomy and an osteoarticular allograft could be used for repairing a significant posterosuperior humeral defect (Hill-Sachs lesion). Shoulder arthroplasty may be tried for treating a humeral bone defect, but more study on this is needed.
Open surgical restoration decreases the risk of recurrence anterior shoulder instability that is combined with a significant osseous defect. Arthroscopic surgery currently has limitations for treating an osseous defect, but it will become useful in proportion to the development of arthroscopic instruments and techniques in the future.
Key Words: Shoulder; Glenoid; Hill-Sachs lesion; Anterior instability; Bone graft; Open technique


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