SHOULDER INSTABILITY
Glenoid
Bone Loss
Glenoid bone loss occurs when part of the front of the shoulder socket is lost after one or more shoulder dislocations. Even relatively small amounts of bone loss can make the shoulder more difficult to stabilize and may significantly influence the type of surgery that provides the best long-term outcome.
Front Of The Socket
Repeated Instability
Loss Of Stability
Depends On The Entire Shoulder
What Is Glenoid Bone Loss?
The glenoid is the socket portion of the shoulder joint. During a shoulder dislocation, the front edge of the socket may fracture or gradually wear away with repeated instability episodes.
As bone is lost, the socket becomes smaller and less able to keep the ball centered during shoulder movement. This increases the likelihood of future dislocations.
Dr. Streit's Clinical Perspective
The shoulder depends on both soft tissues and bone for stability. Once meaningful bone loss develops, simply repairing the labrum may no longer restore normal shoulder stability. My goal is to understand the entire instability pattern before recommending surgery.
How Does Bone Loss Develop?
Initial Dislocation
Bone may fracture during the first instability event.
Repeated Dislocations
Each instability episode may create additional bone loss.
High-Energy Trauma
Major injuries may produce larger defects immediately.
Why Does Bone Loss Matter?
Think of the shoulder socket like a golf tee. If part of the edge is missing, it becomes much easier for the ball to slide off.
Similarly, as the front of the glenoid becomes smaller, the shoulder has less bony support to resist another dislocation.
What I Tell My Patients
"The shoulder doesn't care whether instability comes from a torn labrum, bone loss, or both. It only knows whether it has enough stability to keep the ball centered in the socket."
How Is Glenoid Bone Loss Diagnosed?
History
Number of dislocations and injury mechanism.
Physical Examination
Assessment of instability patterns.
X-rays
May suggest bone loss.
CT Scan
Usually provides the most accurate evaluation for surgical planning.
Does Every Patient With Bone Loss Need A Latarjet Procedure?
No.
Bone loss is one of several important factors considered when planning surgery. The amount and location of bone loss, the condition of the labrum, the size and location of any Hill-Sachs lesion, your age, activity level, sport, and previous instability episodes all contribute to the decision.
Dr. Streit's Treatment Philosophy
I do not recommend surgery based on one measurement alone. Every instability problem is unique. My goal is to identify why your shoulder is unstable and recommend the operation that provides the best chance of long-term success—not simply the operation that addresses one abnormal finding.
Possible Treatment Options
Physical Therapy
Selected patients without recurrent instability may improve without surgery.
Arthroscopic Stabilization
Appropriate for many patients when the overall instability pattern is favorable.
Bone Augmentation Procedures
Procedures such as the Latarjet may be recommended when bone loss significantly contributes to instability.
Related Resources
Concerned About Bone Loss After A Shoulder Dislocation?
A comprehensive evaluation, including advanced imaging when appropriate, can determine whether glenoid bone loss is contributing to your instability and which treatment offers the best chance of restoring long-term shoulder stability.
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