Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

Thus, the concept of {u2018}bipolar bone loss{u2019} has emerged as critical in the surgical treatment of recurrent shoulder instability. Surgeons should adopt a treatment paradigm that focuses on the relationship between both osseous defects and incorporates a surgical tactic to appropriately address each lesion. Pathology related to glenohumeral instability is further described in terms of the tissue avulsed, the location of the avulsion and the pathoanatomic features of the associated osseous injuries.(3). Latarjet procedure has been performed with success in cases with glenoid bone loss to increase the articular arc resulting in decreased rates of recurrence from 67% to 4.9%.(4). Arthroscopic remplissage also prevented engagement when performed as a complementary step in arthroscopic Bankart repair associated with large hill-sachs defects.(5).The purpose of this study was to compare, in a randomized controlled trial, the short-term functional outcome and recurrence rates in patients with significant bipolar bony lesions. Two treatment plans were compared, combined arthroscopic remplissage and open Latarjet procedure versus Latarjet alone. The following were addressed and documented: Radiological assessment and quantification of anterior glenoid bone loss and Hill-Sachs defect using different methods. Postoperative range of motion (ROM) compared to preoperative values. Postoperative constant-Murley and Rowe instability scores compared to preoperative scores. Comparison of the above-mentioned items between both groups. Recurrence of shoulder dislocation in the 2 groups

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