IC 102

No Bone? No Problem. How to Successfully Manage Glenohumeral Instability with Bone Loss 

Gregory L. Cvetanovich MD; Julie Bishop MD; Peter N. Chalmers MD; Brandon J. Erickson MD; Ivan H. Wong MD

Course Description:

In 2015, JBJS published a Topics in Training article titled 'Impact of Fellowship Training in Clinical Practice of Orthopaedic Sports Medicine'.  They surveyed sports medicine trained fellows who had been in practice an average of 9 years, asking in particular, their comfort level with a variety of surgical procedures. Responders displayed a high comfort level with all shoulder procedures, except bone loss instability.  In this case, only 31.5% of responders felt 'very comfortable' treating this entity.  Therefore, the goal of this Instructional Course is to provide an interactive case-based discussion of complex cases in glenohumeral instability with bone loss. A series of illustrative cases will be presented including history, exam findings, and imaging addressing glenoid, humeral, and bipolar bone loss. These cases will be discussed in a larger group. Brief discussion of evidence-based literature for the chosen treatment and technical tips and tricks will then be provided for the chosen treatment.

Course Objectives:

• Understand methods for identifying and quantifying bone loss in the setting of recurrent instability
• Have a better understanding of when it is necessary to address humeral sided bone loss (the Hill-Sachs lesions) and the learn about the most prevalent methods to surgically address the Hill –Sachs lesions
• Grasp the indications for addressing glenoid sided bone loss and the most common techniques to address this bone loss
• Gain a better understanding of the clinical scenarios in which one will encounter posterior glenoid bone loss and learn the best methods to address this pathology
• Learn tips and tricks to assist in executing all the surgical methods discussed

• Gregory L. Cvetanovich MD
• Julie Bishop MD
• Peter N. Chalmers MD
• Brandon J. Erickson MD
• Ivan H. Wong MD
• Benjamin C. Ma MD