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The Management of Anterior Glenohumeral Instability with and without Bone LossAAOS Exhibit Selection
Mark A. Schrumpf, MD1; Travis G. Maak, MD2; Demetris Delos, MD2; Kristofer J. Jones, MD3; David M. Dines, MD2; Gilles Walch, MD4; Joshua S. Dines, MD2
1 San Francisco Shoulder Elbow and Hand Clinic, 2351 Clay Street, Suite 510, San Francisco, CA 94115
2 Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
3 Department of Orthopedic Surgery, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, 76-143 CHS, Los Angeles, CA 90095
4 Centre Orthopedique Santy, 24 Avenue Paul Santy, Lyon F-69008, France
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Investigation performed at the Hospital for Special Surgery, New York, NY

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2014 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2014 Jan 15;96(2):e12 1-10. doi: 10.2106/JBJS.L.01377
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Anterior glenohumeral instability is a common clinical entity with a reported prevalence of 2%1,2. Although the Bankart lesion, or anterior labral detachment, is the most commonly recognized pathologic lesion of traumatic anterior instability, associated osseous deficiencies are also common, particularly in patients with recurrent instability or those with unsuccessful surgical stabilization. Osseous lesions may be present in up to 89% of failed stabilizations3. In this review, we will provide a brief overview of anterior shoulder instability and discuss the implications of bone deficiency in recurrent shoulder instability. Given the increased recognition of these lesions and their contribution to glenohumeral instability, we highlight current treatment considerations relevant to diagnosis, quantification, and preoperative evaluation. Finally, we review the prevailing treatment options to address traumatic anterior glenohumeral instability with and without bone loss.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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