title: Combined glenoid and humeral head allograft reconstruction for recurrent anterior glenohumeral instability.
abstract: Recurrent glenohumeral instability can be a challenging therapeutic problem to orthopedic surgeons. Oftentimes, recurrent anterior glenohumeral instability is associated with a host of capsular, labral, and occasionally, osseous deficiencies. Current treatment strategies for significant bony deficiency within the shoulder are aimed at nonanatomic restoration of glenohumeral anatomy with resultant limitation in range of motion parameters. While these techniques may prevent recurrence of instability, the resulting loss of motion and decreased function may not be suitable for young, active individuals. This case report presents a patient with recurrent anterior glenohumeral instability from a combined, large glenoid and humeral head bone deficiency. A novel surgical technique of restoring both humeral and glenoid bone is introduced as a way to prevent decreased motion after surgery while still maintaining stability. This reconstruction offers a more anatomic restoration of bone deficiency with the desired effect of achieving a more complete postoperative range of motion, while still conferring stability. The patient has returned to activities of daily living.
authors.affiliation: Department of Orthopedic Surgery/2 Silverstein, The Hospital of University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
authors.forename: Fotios P
authors.initials: FP
authors.lastname: Tjoumakaris
authors.forename: Jon K
authors.initials: JK
authors.lastname: Sekiya
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D006801:Humans; D006811:Humerus / Q000601:surgery*; D007593:Joint Instability / Q000517:prevention & control* / Q000601:surgery*; D008297:Male; D055502:Secondary Prevention; D012783:Shoulder Dislocation / Q000517:prevention & control* / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult