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Bone Block for Shoulder Instability

What is a shoulder instability and what causes it?

A shoulder dislocation can be a traumatic and painful injury. It occurs when the ball of the upper arm (humerus) is forced fully out of its normal position within the shoulder socket (glenoid labrum.) This can happen partially, call a subluxation, or completely, called a dislocation, and often requires a reduction (when the bone is located back into the correct position.)  Once a shoulder has been dislocated, the ligaments and Lining of the joint become stretched, resulting in a high risk of recurrent dislocations and shoulder instability.

Dr. Nikhil Verma, orthopedic shoulder surgeon specializes in shoulder instability and can help patients in Westchester, Oakbrook, Hinsdale and surrounding Chicago communities who are suffering from recurrent dislocations, or shoulder instability.

What is glenoid bone loss?

The glenoid, or flat part of the scapula (shoulder blade) is an important part of the shoulder joint. The glenoid has a rim of cartilage, called the labrum, which helps hold the humerus (long arm bone) within the shoulder joint. If a patient has glenoid bone loss, recurrent shoulder dislocations are common. There are several reasons for glenoid bone loss which can include:

  • Recurrent Traumatic shoulder dislocation
  • Fracture of the glenoid

What is a bone block?

A bone block procedure is a successful treatment for shoulder instability and recurrent shoulder dislocation. A bone block uses a small piece of bone from the pelvis or from a bone in the leg (distal tibia) and then relocates it on the edge of the glenoid (part of the shoulder socket.) The bone also contains a cartilage rim to restore the gliding surface of the joint. This procedure reconstructs the shoulder joint, allowing the full range of motion with added stability.

What is an allograft?

An allograft is simply defined as donor tissue. In the case of shoulder instability and a bone block procedure, an allograft is used (harvested) from a donor. All donors are screened appropriately for any communicable diseases and because the bone and cartilage does not contain a high volume of living cells, no immune suppression medications are required. The use of allograft in orthopedic surgery has a long history of success and safety. The piece of bone is screwed into place with two screws, creating the desired bone block. Allografts are desirable, especially in cases where the patient is very active but has 20% or more glenoid bone loss.

Does an allograft bone block work for shoulder instability?

Studies have shown excellent outcomes from bone block allografts, often combined with a Bankart repair (procedure that repairs the cartilage on the glenoid.) Dr. Verma has been successful with this procedure, finding that it restores range of motion, eliminates instability, allowing athletes a high rate of return to competitive sports. In addition, follow up studies with CT scan imaging have shown very high rates of healing and incorporation of the allograft bone.

What is shoulder allograft reconstruction?

An allograft reconstruction typically uses donated tissue or bone to complete the surgical repair. Similarly, an autograft uses the patient’s own tissue or bone to complete the reconstruction. In the bone block procedure, an allograft reconstruction would use a donated piece of bone to create the bone block on the glenoid surface and to restore the cartilage. Dr. Verma has had great success with shoulder allograft reconstruction and recommends it for his patients who are suffering continued shoulder dislocations and shoulder instability.

To learn more about a shoulder bone block and allograft reconstruction for glenoid bone loss or recurrent shoulder instability, please contact Dr. Nikhil Verma, orthopedic shoulder surgeon in the Westchester, Oakbrook, Hinsdale and surrounding Chicago communities.

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