2024 AANA/ISAKOS Specialty Day All-Access Pass-Case Panel Discussion: Instability With Bone Loss

Video Transcription

Video Summary

The panel discussion centers on complex shoulder instability cases, focusing on traumatic subluxations with unusual bone fragments. Surgeons debate diagnosis and treatment strategies using imaging like X-rays and CT scans. The first case involves a 57-year-old male with a free humeral head fragment and tuberosity fracture; experts generally recommend arthroscopic removal of the fragment and conservative treatment, considering patient age and activity. The discussion highlights the complexity of bone loss assessment, surgical approaches including Bankart repair, remplissage, Latarjet, and distal tibial allografts. The second case is a 31-year-old female with chronic instability and failed previous surgeries, including a Latarjet procedure complicated by nerve injury. Panelists favor bone graft reconstruction with distal tibial allograft and arthroscopic remplissage to restore stability, noting the challenge of recurrent instability and bone loss. They emphasize individualized treatment based on patient activity, bone defects, and prior interventions, advocating for advanced imaging and arthroscopic techniques to optimize outcomes and reduce complications.

Asset Caption

Giovanni Di Giacomo, M.D., John M. Tokish, M.D., FAANA, Patrick J. Denard, M.D., FAANA, Seth Gamradt, M.D., Michael J. Pagnani, M.D., Jeanne Cameron Patzkowski, M.D., FAANA, Ivan H. Wong, M.D., FAANA

Keywords

shoulder instability

traumatic subluxation

bone fragments

arthroscopic surgery

Latarjet procedure

distal tibial allograft