This article is more than 5 years old. Information may no longer be current.

Glenoid bone loss best managed with combined techniques, surgeon expertise

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

GENEVA —  To correct cases of complex shoulder bone loss and instability, surgeons should rely on their knowledge base for successful outcomes and not on evidence-based medicine alone, according to a Norwegian keynote lecturer at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012, here.

“In really complex cases like this, you cannot rely on performed studies. You need to combine techniques and always try to find the best solution,” Tom C. Ludvigsen, MD, said. “You need really a large toolbox to take care of these patients and must combine the tools that you have.”

He added, “In this situation, extensive knowledge of anatomy and function is critical.”

 

Tom C. Ludvigsen

Different amounts of bone loss in shoulder instability cases require variations in the procedures the orthopaedist uses, Ludvigsen said. In his own practice, Ludvigsen said he uses an open Latarjet procedure or arthroscopic Bankart repair when there is no evidence of bone loss. However, for moderate bone loss, he does bone grafting with a Bankart procedure and a Remplissage combination technique or open Latarjet technique, he said.

Ludvigsen noted that Latarjet surgery for the shoulder has a low recurrence rate of 3%. However, in the literature it has been associated with osteoarthritic complications and loss of internal rotation. Still, in cases with a large amount of bone loss, Ludvigsen said he combines a bone grafting and modified Latarjet procedure.

“It has been very useful in my practice and is tolerated well and has excellent stability,” he said, noting that in his patients this combination of arthroscopic shoulder procedures has shown no signs of osteoarthritis.

Reference:

Ludvigsen TC. Complex instability problems related to bony deformities. Paper #KN25-5055. Presented at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012. May 2-5. Geneva.