Long-Term Restoration of Anterior Shoulder Stability: A Retrospective Analysis of Arthroscopic Bankart Repair Versus Open Latarjet Procedure

The Epidemiology and Natural History of Anterior Shoulder Instability

PURPOSE OF REVIEW

The purpose of this review is to outline the natural history and best clinical practices for nonoperative management of anterior shoulder instability.

RECENT FINDINGS

Recent studies continue to demonstrate a role for nonoperative treatment in the successful long-term management of anterior glenohumeral instability. The success of different positions of shoulder immobilization is reviewed as well. There are specific patients who may be best treated with nonoperative means after anterior glenohumeral instability. There are also patients who are not good nonoperative candidates based on a number of factors that are outlined in this review. There continues to be no definitive literature regarding the return to play of in-season athletes. Successful management requires a thorough understanding of the epidemiology, pathoanatomy, history, physical examination, diagnostic imaging modalities, and natural history of operative and nonoperative treatment.

Management of Glenoid Bone Loss with Anterior Shoulder Instability: Indications and Outcomes

PURPOSE OF REVIEW

Glenoid Bone Loss is a commonly encountered problem in anterior shoulder instability. In this article, we review current techniques for diagnosis, indications and management of glenoid bone loss.

RECENT FINDINGS

Multiple bone grafting techniques are available depending on the glenoid defect size including the coracoid, distal clavicle, iliac crest, and allograft distal tibia. Advancement in imaging methods allows for more accurate quantification of bone loss. Indications and techniques are continuing to evolve, and emerging evidence suggests that smaller degrees of bone loss "subcritical" may be best treated with bone grafting. Future directions for innovation and investigation include improved arthroscopic techniques and a refinement of indications for the type of bone grafts and when to indicate a patient of arthroscopic repair versus glenoid bone grafting for smaller degrees of bone loss to ensure successful outcome.