THE MANAGEMENT OF RECURRENT SHOULDER INSTABILITY ASSOCIATED WITH BONE LOSS

Abstract

The aim of this study was to review the results of surgery on patients who had recurrent instabilty of the shoulder associated with significant bone loss who were treated by autogenous iliac crest tricortical grafts. Ten consecutive patients were reviewed. All had significant loss of glenoid bone stock as assessed by CT scan. All were treated by use of tricortical bone graft harvested from the iliac crest and fashioned to reconstitute the anterior glenoid defect. This was fixed intra-articularly with cannulated screws. The antero-inferior capsule was then repaired to this new “glenoid rim”. All patients had a standard rehabilitation regime. All patients had an assessment of the Oxford Shoulder Instability Score (OIS) and the American Shoulder and Elbow Surgeons Score (ASES) before and after the operation. At an average follow-up of 26 months, the mean OIS had improved from 38.3 to 22.3 and the mean ASES had increased from 40.5 to 86.6. None had had a recurrent dislocation. The use of autogenous iliac crest bone graft to treat recurrent shoulder instability associated with significant glenoid bone loss is an effective treatment for this difficult condition.