What is Bone Graft Surgery as a Shoulder Instability Treatment?

The shoulder joint is extremely mobile, allowing for a wide range of motion, including rotation, lifting, and overhead reaching. However, this mobility also increases the risk of shoulder dislocations and, ultimately, shoulder instability. Shoulder instability occurs when the ball (humeral head) is repeatedly forced out of the socket (glenoid bone), making future dislocations more likely. In cases of recurrent instability, bone loss can occur in both the ball (humeral head) and socket (glenoid bone). Severe bone loss compromises shoulder stability, increasing the likelihood of further dislocations.

In such cases, bony augmentation using an autograft (from the patient) or allograft (from a cadaveric source) is the preferred treatment. This procedure, performed by Dr. Khaleel, Senior Consultant Arthroscopic Shoulder and Sports Surgeon at Kims Alshifa, Perintalmanna, Kerala, India, restores the bony integrity of the joint and resolves shoulder instability.

What is Bone Loss in the Shoulder?

Severe shoulder instability with significant bone loss presents unique treatment challenges due to the compromised bony structure. Studies have shown that in cases of severe bone loss, soft tissue repair alone, including arthroscopic stabilization surgery, may not provide adequate stability. Instead, bone graft surgery has been found to be a more effective treatment.

Several bone graft techniques have been used successfully to treat glenoid bone loss, including:

• Coracoid Process Graft: Using a portion of the coracoid process to reinforce the glenoid bone.
• Iliac Crest Autograft: Harvesting bone from the iliac crest of the pelvis for grafting.
• Distal Tibia Allograft: Using cadaveric bone from the distal tibia to reconstruct the glenoid surface.

Glenoid bone loss has been found in up to 22% of patients after a single dislocation and is a leading cause of failure in arthroscopic instability repairs. To assess the extent of bone loss in the glenoid and humeral head, Dr. Khaleel employs advanced imaging techniques, including traditional x-rays and 3D CT scans, to obtain a precise evaluation and develop a customized treatment plan.

Treatment Plan

In addition to imaging, Dr. Khaleel performs a comprehensive physical examination to assess shoulder instability. Generally, arthroscopic techniques are reserved for patients with minor bony defects, while open surgery with bone grafting is recommended for severe bone loss.

At the initial consultation, Dr. Khaleel will discuss all available treatment options for patients with severe bone loss in the shoulder joint. He will provide a detailed explanation of the recommended approach to restore shoulder stability effectively.

If you have experienced recurrent shoulder instability or bone loss and are seeking expert treatment, contact Dr. Khaleel, Senior Consultant Arthroscopic Shoulder and Sports Surgeon at Kims Alshifa, Perintalmanna, Kerala, India, for a thorough evaluation and a personalized treatment plan.