Bipolar Bone Loss of the Shoulder Joint due to Recurrent Instability: Use of Fresh Osteochondral Distal Tibia and Humeral Head Allografts

• Published in: Arthroscopy techniques (Amsterdam) Vol. 6; no. 3; pp. e893 - e899
• Main Authors: Haber, Daniel B., M.D, Sanchez, Anthony, B.S, Sanchez, George, B.S, Ferrari, Marcio B., M.D, Ferdousian, Sami, B.S, Provencher, Matthew T., M.D
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.06.2017; Elsevier
• Subjects: Orthopedics; Technical Note
• ISSN: 2212-6287; 2212-6287
• DOI: 10.1016/j.eats.2017.02.022

Abstract With increasing shoulder instability events, the likelihood of a bony lesion of the glenoid and/or humeral head rises. Although bone loss of either the glenoid or humeral head may result in recurrent instability, bipolar lesions have been shown, in particular, to result in a negative and additive effect on glenohumeral stability. In the case of a bipolar lesion comprising severe glenoid bone loss and an engaging, “off-track” Hill-Sachs lesion, the bony foundation of the glenohumeral joint is compromised and bony augmentation is necessary. We present our preferred technique, made up of the application of a distal tibia allograft to address the glenoid bone loss and humeral head allograft to address the Hill-Sachs lesion, for the treatment of a severe bipolar lesion in the setting of recurrent anterior shoulder instability after a failed Latarjet procedure.