Bony lesions are highly prevalent in anterior shoulder instability and can be a significant cause of failure of stabilisation procedures if they are not adequately addressed. The glenoid track concept describes the dynamic interaction between the humeral head and glenoid defects in anterior shoulder instability. It has been beneficial for understanding the role played by bone defects in this entity. As a consequence, the popularity of glenoid augmentation procedures aimed to treat anterior glenoid bone defects; reconstructing the anatomy of the glenohumeral joint has risen sharply in the last decade. Although bone defects are less common in posterior instability, posterior bone block procedures can be indicated to treat not only posterior bony lesions, attritional posterior glenoid erosion or dysplasia but also normal or retroverted glenoids to provide an extended glenoid surface to increase the glenohumeral stability. The purpose of this review was to analyse the rationale, current indications and results of surgical techniques aimed to augment the glenoid surface in patients diagnosed of either anterior or posterior instability by assessing a thorough review of modern literature. Classical techniques such as Latarjet or free bone block procedures have proven to be effective in augmenting the glenoid surface and consequently achieving adequate shoulder stability with good clinical outcomes and early return to athletic activity. Innovations in surgical techniques have permitted to perform these procedures arthroscopically. Arthroscopy provides the theoretical advantages of lower morbidity and faster recovery, as well as the identification and treatment of concomitant pathologies.
- treatment / technique
- orthopedic procedures
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Contributors EC led the team in the manuscript preparation; wrote the 'Arthroscopic' 'Latarjet', 'Abstract' and 'Future perspectives' sections; and edited the whole manuscript. EI wrote the 'Introduction' section and edited the whole manuscript. PL wrote the 'Open Latarjet' section and edited the whole manuscript. GA wrote the 'Glenoid bone augmentation for posterior shoulder instability' section and edited the whole manuscript. NY wrote the 'Introduction' section. JM, SS and IW wrote the 'Free bone block procedures for anterior instability' section. IW edited the whole manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests EC reports personal fees from Smith & Nephew and DePuy Synthes during the conduct of the study, and also personal fees from Wright and Stryker outside the submitted work. PL reports personal fees from Smith. & Nephew outside the submitted work. Other coauthors have nothing to disclose.
Provenance and peer review Commissioned; externally peer reviewed.
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