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1. E. Mataragas, C. Vassos, N. Tzanakakis, G. Mouzopoulos,
C.K. Yiannakopoulos, Emm. Antonogiannakis
2nd
Orthopaedic Dpt. – Shoulder and Arthroscopy Unit,
IASO GENERAL Hospital

2.  Age of 1st
Dislocation
 Loose Joints
 Overhead Profession
 Overhead/Contact Sports
 Collagen Related Pathology
 Number of Dislocations
 Osseous Defects
Rockwood Ch A Jr., THE SHOULDER 4th
ED.

3. There is a well-recognized association between
osseous defects of the glenoid or humerus and
shoulder dislocation, which often leads to
recurrent instability.
Boileau P., J Bone Joint Surg Am. 2006 Aug;88(8):1755-63.
Lynch JR., J Shoulder Elbow Surg. 2009 Mar-Apr;18(2):317-28.
Burkhart SS., Instr Course Lect. 2009;58:323-36.

4. To evaluate humeral and glenoid bone loss, in
patients arthroscopically treated for shoulder
instability, as factors of recurrence.

5.  Retrospective, continuous, monocentric.
 Series of 114 patients from 2000-2008.
One surgeon performed all the procedures!

6. Glenoid Index in 3D CT scan of both shoulders
Critical Limit Glenoid index 0.75
SS Burkhart Arthroscopy: Vol 24, No 4 (April), 2008: pp 376-382

7. Taverna et al. Pico Method 2D CT –
measurement of glenoid surface Critical Limit
25% loss of glenoid surface

8. Scope on anterior portal, measurement of
anteroposterior defect width
Sugaya et al. JBJS Am 2005

10. Arm at 35˚Abduction Neutral rotation

11. -Mean age of patients: 28
1st
episode: 21
dislocations: 17
Men: v=103
Women: v=11
-Revision surgery: 7

12. Athletes: 75
15 Overhead
23 Contact
22 Overhead & Contact
No sports: 39

13. Complete follow up existed for 92 patients.
Follow up ranged from 4-108 months (Mean=44).
Post op rehabilitation was supervised by a doctor
dedicated to shoulder problems.
Recurrence and functional outcome were
evaluated pre-op and post-op with the Rowe Zarins
Score.

14. Osseous Lesions:
Hill Sachs 97
(66 Large, 23 Medium & 8 Small)
Glenoid Bone loss 104
(16 Large, 59 Medium & 29 Small)
“Inverted pear” glenoid shape 13
“Bony” Bankart Lesion 13

15. Bankart LesionsBankart Lesions
77/11477/114
(67,5%)(67,5%)
RC TearRC Tear 18/114 (15,8%)18/114 (15,8%)
SLAPSLAP
44/11444/114
(38,6%)(38,6%)
ALPSAALPSA
24/11424/114
(21,6%)(21,6%)

16. Recurrence of instability was noted in 5
patients (4,38%): 2 MVA
2 Fall
1 Involuntary

17. All 5 of them presented Hill Sachs lesions.
Their glenoid bone loss was measured as:
(2 Large, 2 Medium, 1 Small)
None showed “inverted pear” glenoid shape.
None presented with joint hypermobility.
All 5 of them were into Overhead/Contact sports.
(2 Professional: Mean=15hr/w and 3 Amateur: Mean=2,5hr/w).

18. All 5 patients were reoperated arthroscopically
and have not showed recurrent instability so far.

19. Patient Satisfaction
87 Very Satisfied/ 5 Satisfied 94,6% / 5,4%
Return to Work 100%
Return to Sports
50 patients (mostly because they didn’t try) 66,6%

20. Pre-Op Post-Op p
Rowe Zarins 33 95 < 0.05
Range of Scores
Pre-op: 15-80
Post-op: 80-100

21. At least in this series, it seems that humeral
and glenoid bone loss do not significantly
contribute to the recurrence of
arthroscopically treated shoulder instability.