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Glenohumeral Joint Preservation With Allograft: Surgical Technique

February 19, 2016

Contributors: Petar Golijanin, BS; Bryan George Vopat, MD; Anthony A Romeo, MD, FAAOS; CAPT (Ret) Matthew T. Provencher, MD MC USNR; Rachel M Frank, MD; Rachel M Frank, MD

Bone defects in patients with recurrent anterior shoulder instability may be difficult to manage. An intact glenoid articular arc is crucial for a stable articulation with the humeral head, and loss of articular congruency may be detrimental in patients with recurrent anterior shoulder instability. In general, defects that are less than 15% of the glenoid width can be managed via soft-tissue stabilization alone, whereas defects that are greater than 30% of the glenoid width often require autograft or allograft glenoid augmentation. Defects that are between 15% to 30% of the glenoid width are in an indeterminate zone, and pathology- and patient-specific factors drive decision making for surgical repair. This video describes the surgical techniques for glenohumeral joint preservation, with allograft reconstruction of the glenoid and management of recurrent humeral head instability if bone loss is a contributing causative factor. Several specific bone grafting techniques, such as the Latarjet procedure, autograft augmentation, and allograft bone augmentation are highlighted, and pearls are discussed to help achieve successful and reproducible results.