Arthroscopic Glenoid Bone Grafting

Arthroscopic Glenoid Bone Grafting

Arthroscopic glenoid bone grafting is a minimally invasive surgical procedure used to address bone loss in the glenoid cavity of the shoulder, Dr. Kelechi Okoroha, provides diagnosis and individualized nonoperative and operative treatments in Minneapolis. He also provides highly specialized care during and after surgery. Contact Dr. Okoroha’s team for an appointment today!

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What is Arthroscopic Glenoid Bone Grafting?

Arthroscopic glenoid bone grafting is a minimally invasive surgical procedure used to address bone loss in the glenoid cavity of the shoulder. The glenoid cavity is the part of the scapula (shoulder blade) that forms the socket for the ball of the humerus (upper arm bone) to create the shoulder joint. This procedure is often performed in cases of recurrent shoulder dislocations or instability, particularly when there is significant bone loss on the glenoid side.

Indications for Arthroscopic Glenoid Bone Grafting

Your surgeon may recommend arthroscopic glenoid bone grafting in the following scenarios:

• Recurrent Shoulder Dislocations: Patients who experience frequent dislocations due to traumatic injuries or chronic instability.
• Bone Loss: Significant loss of bone in the glenoid cavity, which can compromise the stability of the shoulder joint.
• Failed Previous Surgeries: Patients who have undergone previous shoulder stabilization procedures without success.

Preparation for Arthroscopic Glenoid Bone Grafting

In general, preoperative preparation for arthroscopic glenoid bone grafting may include the following:

• A thorough review of the patient's medical history, including medications, allergies, and underlying health conditions.
• Physical examination to assess the extent of shoulder instability, range of motion, and strength.
• Imaging studies such as X-rays and MRI to assess the bone structure, soft-tissue structures of the shoulder, and the level of glenoid bone loss.
• Based on the imaging studies, a detailed surgical plan is created, including the type and size of the bone graft needed and the fixation method.
• Review and adjust any medications the patient is taking. Certain medications, such as blood thinners, may need to be discontinued before surgery.
• Patients are typically instructed to fast (no food or drink) for a specified period before surgery, usually starting at midnight the night before the procedure.

Procedure for Arthroscopic Glenoid Bone Grafting

In general, the minimally invasive arthroscopic glenoid bone grafting surgery may include the following steps:

• The patient is typically placed under general anesthesia. The affected shoulder is prepped and draped in a sterile manner.
• Small incisions (portals) are made around the shoulder to insert an arthroscope, a small tubular instrument with a camera, and surgical instruments.
• The arthroscope is introduced into the shoulder joint to provide a clear view of the internal structures on a monitor.
• The surgeon examines the inside of the shoulder joint to assess the extent of bone loss and any associated damage.
• A bone graft is usually taken from another part of the patient's body, commonly the iliac crest (part of the pelvis), or from a donor (allograft).
• The glenoid cavity is prepared to receive the bone graft. This may involve debriding (cleaning) the area and creating a space for the graft.
• The bone graft is shaped and positioned into the prepared glenoid cavity. It is secured using screws or other fixation devices to ensure it stays in place.
• The arthroscope and instruments are removed. The small incisions are closed with sutures or surgical tape. A sterile dressing is applied to the surgical site.

Postoperative Care and Recovery

In general, postoperative care and recovery after arthroscopic glenoid bone grafting surgery may include the following:

• After the surgery, the patient is monitored in the recovery room until they wake up from anesthesia and their vital signs are stable.
• The shoulder is immobilized using a sling or shoulder brace to protect the surgical site and limit movement.
• The patient may experience pain, swelling, and discomfort in the shoulder area. Pain and anti-inflammatory medications are provided as needed to address these.
• The patient should avoid using the affected arm for any heavy lifting, reaching, or overhead activities for a defined period.
• An individualized physical therapy protocol is designed to help strengthen shoulder muscles and optimize shoulder function.
• Patients should be able to resume their normal daily activities in 3 to 4 weeks but with certain activity restrictions. Return to sports may take 6 months or longer.
• Regular follow-up visits will be scheduled with the surgeon to monitor the long-term success of the procedure.

Risks and Complications

As with any surgery, some risks and complications may occur with arthroscopic glenoid bone grafting. These include:

• Infection
• Bleeding
• Graft nonunion or failure
• Hardware complications
• Persistent instability or recurrence of dislocations
• Stiffness or limited range of motion
• General anesthesia risks

Benefits

Benefits of arthroscopic glenoid bone grafting surgery include:

• Restores the normal anatomy of the glenoid, providing better stability to the shoulder joint.
• Minimally invasive approach with the benefits of arthroscopy, such as smaller incisions, less pain, minimal scarring, and faster recovery compared to open surgery.