2023 Specialty Day Access Pass-Subcritical Bone Loss: So Many Options!

Video Transcription

Video Summary

In a dynamic panel discussion led by John Dickens, experts debated optimal surgical approaches for subcritical bone loss in shoulder instability, focusing on two patient cases. For a 16-year-old athlete with ~9% glenoid bone loss and on-track Hill-Sachs lesion, options included Latarjet versus open Bankart repair. Joe Eichinger favored Latarjet for its bone graft advantage and durability in contact sports despite technical challenges, while Corey Edgar advocated open Bankart with capsular tightening due to lower complication risks. Return-to-play criteria were also considered, emphasizing time, strength symmetry, and sport-specific demands. For a 21-year-old military patient with minimal glenoid loss but larger Hill-Sachs lesion, the debate centered on Latarjet versus arthroscopic Bankart with Remplissage. Panelists cited Latarjet’s lower recurrence but higher complication and arthroplasty difficulty; some preferred Bankart-Remplissage for less invasive management. Overall, treatment was individualized based on bone loss extent, patient activity, sport, and risk-benefit profiles, with consensus that Latarjet suits high-risk, collision athletes while Bankart ± Remplissage suits others.

Asset Caption

Moderator: Jonathan F. Dickens, M.D., L.T.C., M.C.
Panel: Michael Fu, M.D., MHS, Jeanne C. Patzkowski, M.D., Josef K. Eichinger, M.D., FAANA, Cory Edgar, M.D., Ph.D.

Keywords

shoulder instability

subcritical bone loss

Latarjet procedure

Bankart repair

Hill-Sachs lesion