Arthroscopic Assisted Glenoid Reconstruction for Recurrent Anterior Glenohumeral Instability combined with Glenoid insufficiency

Elshaer, Ahmed Mohamed; Shalaby, Mohamed Safwat Moustafa; Megahed, Riad Mansour; Abdelsalam, Mohamed Abdallah

doi:10.21608/zumj.2021.79161.2252

Arthroscopic Assisted Glenoid Reconstruction for Recurrent Anterior Glenohumeral Instability combined with Glenoid insufficiency

Document Type : Original Article

Authors

¹ orthopaedic departement_faculty of medicine-zagazig university

² Department of Orthopedic Surgery, Faculty of Medicine Zagazig University, Egypt.

³ Orthopedic Surgery Department Faculty of Medicine; Zagazig University Zagazig, Egypt

⁴ orthopaedic departement. faculty of medicine, zagazig university

10.21608/zumj.2021.79161.2252

Abstract

Background: Anterior recurrent glenohumeral instability is a common clinical entity, particularly among young athletic patient population with glenoid defect greater than 20%. Glenoid reconstruction with bone graft has become the treatment of choice.
Aim of the work: evaluate the role of arthroscopic assisted reconstruction in management of recurrent anterior glenohumeral instability associated with glenoid insufficiency.
Patients and Methods: Our prospective study was conducted involving 30 cases with anterior shoulder instability associated with glenoid defect more than 20%. All patients were operated at Zagazig University Hospitals. All cases were surgically managed by arthroscopic assisted reconstruction the glenoid defect by bone graft. 15 cases with coracoid process and 15 cases with tricortical iliac crest graft.
Results: 30 patients were followed up for 12 monthes. All patients showed significant improving in the range of motions. No dislocation or subluxation recorded in any patients. All graft complete bony union except one showed fibrous union. UCLA and Consatnt score highly significant improved postoperative.
Conclusion: Soft-tissue stabilization procedures for the treatment of anterior shoulder instability were proved to be less effective with high recurrence rate up to 67% in patients with extensive glenoid bone loss >20 %. So, bone grafting techniques instead of soft tissue stabilization procedures in the case of extensive glenoid bone loss > 20 %.

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