Bone Loss of The Glenoid and Humerus: A concern for Failure in the Setting of Glenohumeral Instability

Glenohumeral instability is often characterized by progressive bipolar bone loss, a clinical phenomenon that not only complicates the management of recurrent shoulder dislocations but portends an increased risk for failure following soft-tissue stabilization procedures. This review synthesizes the history and pathophysiology of humeral and glenoid bone loss, delineates critical and subcritical thresholds, and emphasizes the necessity of a comprehensive diagnostic and surgical approach in the evaluation and treatment of patients with glenoid and/or humeral bone loss. The dynamic nature of bony injury in shoulder instability highlights the importance of tailored interventions to address bipolar bone loss and restore shoulder stability and function. Through an in-depth examination of contemporary strategies for managing glenohumeral instability, including the employment of advanced imaging techniques and refined surgical methods, this chapter offers guidance on an optimal clinical approach. By focusing on improving surgical outcomes and patient function, this review aims to navigate the complexities of shoulder instability, underscoring the importance of an integrated approach to patient care.