title: Bipolar bone defect in the shoulder anterior dislocation.
abstract: In the anterior shoulder instability with glenoid bone loss among 25 % or more of the inferior glenoid diameter (inverted-pear glenoid), the consensus of recent authors is that glenoid bone grafting (Latarjet procedure) should be performed. The engaging Hill-Sachs lesion has been recognized as a risk factor for recurrent anterior shoulder instability. We have developed a method using radiographic and arthroscopic studies and the concept of the glenoid track to determine whether a Hill-Sachs lesion will engage the anterior glenoid rim, whether or not there is concomitant anterior glenoid bone loss. If the Hill-Sachs lesion engages, it is called an "off-track" Hill-Sachs lesion; if it does not engage, it is an "on-track" lesion. On the basis of our quantitative method, we have developed a treatment paradigm with specific surgical criteria for all patients with anterior shoulder instability (first dislocation or recurrent dislocation), both with and without bipolar bone loss.
authors.affiliation: Department of Orthopaedic Surgery, Concordia Hospital for "Special Surgery", Via delle Sette Chiese 90, 00145, Rome, Italy. concordia@iol.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Giacomo
authors.affiliation: Department of Orthopaedic Surgery, Concordia Hospital for "Special Surgery", Via delle Sette Chiese 90, 00145, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: de Gasperis
authors.affiliation: Department of Orthopaedic Surgery, Concordia Hospital for "Special Surgery", Via delle Sette Chiese 90, 00145, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Scarso
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D016025:Bone Transplantation; D005260:Female; D051445:Fibrocartilage / Q000293:injuries / Q000601:surgery; D006801:Humans; D058430:Humeral Head / Q000293:injuries / Q000601:surgery; D017746:Joint Capsule / Q000293:injuries / Q000601:surgery; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012540:Scapula / Q000293:injuries / Q000601:surgery; D012783:Shoulder Dislocation / Q000601:surgery* / Q000628:therapy; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D055815:Young Adult
keywords: Bankart lesion; Bankart repair; Bone loss; Glenoid defect; Hill–Sachs; Humeral defect; Instability; Latarjet; Off-track; On-track; Remplissage; Shoulder; Shoulder instability