Recurrent Shoulder Instability Associated with Bony Defects: A Current Review

2 Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY The glenohumeral joint is one of great mobility facilitated through the complex interplay of soft tissue and osseous anatomy. Arthroscopic shoulder stabilization has become the standard of care in the surgical management of glenohumeral instability. However, the management of the unstable shoulder associated with a bony defect (glenoid, humeral or combined) can be challenging and preclude arthroscopic treatment. Adequate diagnosis of bony defects is paramount to successful treatment and entails a careful history, clinical exam, and specific radiographic imaging. In general, higher energy shoulder trauma leads to more significant glenoid and/or humeral head defects. In addition, the severity of these defects corresponds with the number and frequency of instability episodes. Non-operative methods of treatment are not sufficient for treating these cases. Although successful arthroscopic management of instability associated with osseous defects has been described, open reconstruction is often indicated.