Knöcherne Augmentationsverfahren bei anteroinferioren Glenoiddefekten

Ventral shoulder dislocations frequently lead to bony defects in the anteroinferior region of the glenoid. Due to the loss of joint surface and concavity even minor defects can have a negative impact on shoulder stability and defects over ca. 10% should be considered in the treatment planning. For larger glenoid defects, insufficient soft tissue situations or comorbid relevant humeral defects, bony reconstruction techniques are employed. Biomechanically, the most stable technique is probably the Latarjet procedure, although it might not be the optimal choice for all patients due to potential movement restrictions and relatively high invasiveness. Alternatively, various techniques for transferring a free bone block provide great flexibility in terms of shape, size and properties of the graft. Bone block techniques potentially provide restoration of native biomechanics with optimal mobility. Common to all these procedures is the successful restoration of glenohumeral stability with very good outcomes, low recurrence and revision rates as well as high return to sport rates. The further development of arthroscopic procedures and the use of non-rigid fixation techniques offer low invasiveness, rapid rehabilitation and potentially reduced complication rates. Given the variety of available treatment options it is now essential that modern management of shoulder instability should be individually tailored, taking patient-specific factors into account.