(English) Episode 255-Posterior shoulder instability and bone loss

This medical review examines the pathophysiology, diagnosis, and surgical management of posterior shoulder instability, specifically when complicated by glenohumeral bone loss. While this condition represents a small fraction of all instability cases, it frequently affects young athletes and can be identified through specific provocative maneuvers like the Jerk and Kim tests. Advanced 3D imaging is essential for quantifying defects in the posterior glenoid and humeral head to determine if soft tissue repair alone will suffice. When bone loss exceeds critical thresholds, surgeons may employ bone block procedures using iliac crest autografts or distal tibial allografts to restore joint stability. The text also details specialized techniques for treating reverse Hill-Sachs lesions and complex bipolar defects to improve long-term patient outcomes.Trivellas M, Hoyt B, Bokshan S, Dickens JF, Lau BC. Evolving concepts in the treatment of posterior shoulder instability with glenohumeral bone loss. Ann Jt [Internet]. 2024;9:28. Available from: http://dx.doi.org/10.21037/aoj-23-45