Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability

Introduction: The glenohumeral joint is one with the greatest mobility and intimate contact between the articular surfaces of the humeral head and glenoid labrum contributes to its stability. Patients with recurrent dislocations have bone deficits in one or both of these surfaces, due to the presenc...

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Main Authors:	Tengku Mohamed Shihabudin, Tengku Muzaffar, Sharifudin, Mohd Ariff, Mohamed Muslim, Darhaysham Al Jefri
Format:	Conference or Workshop Item
Language:	English English English English
Published:	2012
Subjects:	RC1200 Sports Medicine RD701 Orthopedics RZ301 Osteopathy
Online Access:	http://irep.iium.edu.my/29392/ http://irep.iium.edu.my/29392/1/MOA_2012_-_DrMohdAriffS_-_Poster_-_Open_Bone_Augmentation.pdf http://irep.iium.edu.my/29392/2/MOA_2012_-_Cover.pdf http://irep.iium.edu.my/29392/3/PP.009.SPORTS.185_Dr_Mohd_Ariff_Sharifudin.pdf http://irep.iium.edu.my/29392/4/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Content_Page_59-67%29.pdf

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spelling	iium-293922013-03-05T05:48:42Z http://irep.iium.edu.my/29392/ Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability Tengku Mohamed Shihabudin, Tengku Muzaffar Sharifudin, Mohd Ariff Mohamed Muslim, Darhaysham Al Jefri RC1200 Sports Medicine RD701 Orthopedics RZ301 Osteopathy Introduction: The glenohumeral joint is one with the greatest mobility and intimate contact between the articular surfaces of the humeral head and glenoid labrum contributes to its stability. Patients with recurrent dislocations have bone deficits in one or both of these surfaces, due to the presence of a Bankart lesion or an engaging Hill-Sachs lesion. Although successful arthroscopic management of instability associated with osseous defects is an alternative, open reconstruction is often indicated. Large osseous defects can be challenging and preclude arthroscopic treatment. Case Report: A 30-year-old man with a history of chronic, recurrent left shoulder dislocation for more than 10 years was referred to us for further evaluation and treatment. Our assessment revealed a large Bankart lesion combined with a large Hill Sach lesion over the humeral head. Open reduction with bone augmentation of the glenoid osseous defect was performed using autogenous bone graft from the iliac crest. Intraoperative assessment showed adequate stability for the humeral head defect without the need for intervention. The technical aspect of the surgery is described together with the clinical outcomes of the patient. Discussion/Conclusion: An estimated osseous defect with a width of 20% of the glenoid length remains unstable and requires bone augmentation. Bone grafting was the stabilizing mechanism in the restoration of the glenoid concavity. Most patients with bone deficits on both articular surfaces can suitably be treated by reconstructing only one of the deficits, but occasionally both defects may require intervention. To date, there are no validated preoperative guidelines for cases when both procedures are required. An intra-operative assessment remains our best tool. 2012 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/29392/1/MOA_2012_-_DrMohdAriffS_-_Poster_-_Open_Bone_Augmentation.pdf application/pdf en http://irep.iium.edu.my/29392/2/MOA_2012_-_Cover.pdf application/pdf en http://irep.iium.edu.my/29392/3/PP.009.SPORTS.185_Dr_Mohd_Ariff_Sharifudin.pdf application/pdf en http://irep.iium.edu.my/29392/4/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Content_Page_59-67%29.pdf Tengku Mohamed Shihabudin, Tengku Muzaffar and Sharifudin, Mohd Ariff and Mohamed Muslim, Darhaysham Al Jefri (2012) Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability. In: 42nd Malaysian Orthopaedic Association Meeting/Annual Scientific Meeting, 14-17 June 2012, Zenith Hotel, Kuantan, Pahang. (Unpublished)
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English English
topic	RC1200 Sports Medicine RD701 Orthopedics RZ301 Osteopathy
spellingShingle	RC1200 Sports Medicine RD701 Orthopedics RZ301 Osteopathy Tengku Mohamed Shihabudin, Tengku Muzaffar Sharifudin, Mohd Ariff Mohamed Muslim, Darhaysham Al Jefri Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
description	Introduction: The glenohumeral joint is one with the greatest mobility and intimate contact between the articular surfaces of the humeral head and glenoid labrum contributes to its stability. Patients with recurrent dislocations have bone deficits in one or both of these surfaces, due to the presence of a Bankart lesion or an engaging Hill-Sachs lesion. Although successful arthroscopic management of instability associated with osseous defects is an alternative, open reconstruction is often indicated. Large osseous defects can be challenging and preclude arthroscopic treatment. Case Report: A 30-year-old man with a history of chronic, recurrent left shoulder dislocation for more than 10 years was referred to us for further evaluation and treatment. Our assessment revealed a large Bankart lesion combined with a large Hill Sach lesion over the humeral head. Open reduction with bone augmentation of the glenoid osseous defect was performed using autogenous bone graft from the iliac crest. Intraoperative assessment showed adequate stability for the humeral head defect without the need for intervention. The technical aspect of the surgery is described together with the clinical outcomes of the patient. Discussion/Conclusion: An estimated osseous defect with a width of 20% of the glenoid length remains unstable and requires bone augmentation. Bone grafting was the stabilizing mechanism in the restoration of the glenoid concavity. Most patients with bone deficits on both articular surfaces can suitably be treated by reconstructing only one of the deficits, but occasionally both defects may require intervention. To date, there are no validated preoperative guidelines for cases when both procedures are required. An intra-operative assessment remains our best tool.
format	Conference or Workshop Item
author	Tengku Mohamed Shihabudin, Tengku Muzaffar Sharifudin, Mohd Ariff Mohamed Muslim, Darhaysham Al Jefri
author_facet	Tengku Mohamed Shihabudin, Tengku Muzaffar Sharifudin, Mohd Ariff Mohamed Muslim, Darhaysham Al Jefri
author_sort	Tengku Mohamed Shihabudin, Tengku Muzaffar
title	Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_short	Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_full	Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_fullStr	Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_full_unstemmed	Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_sort	open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
publishDate	2012
url	http://irep.iium.edu.my/29392/ http://irep.iium.edu.my/29392/1/MOA_2012_-_DrMohdAriffS_-_Poster_-_Open_Bone_Augmentation.pdf http://irep.iium.edu.my/29392/2/MOA_2012_-_Cover.pdf http://irep.iium.edu.my/29392/3/PP.009.SPORTS.185_Dr_Mohd_Ariff_Sharifudin.pdf http://irep.iium.edu.my/29392/4/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Content_Page_59-67%29.pdf
first_indexed	2023-09-18T20:43:09Z
last_indexed	2023-09-18T20:43:09Z
_version_	1777409499393425408

Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability

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