Evaluating Bone Loss in Anterior Shoulder Instability

Eric C. Makhni, MD, MBA; Joseph S. Tramer, MD; Matthew J.J. Anderson, MD; William N. Levine, MD


J Am Acad Orthop Surg. 2022;30(12):563-572. 

In This Article


The evaluation and management of anterior shoulder instability frequently presents unique challenges for the treating orthopaedic surgeon, particularly in patients with glenohumeral bone loss. In such patients, the degree of glenohumeral bone loss often has implications for both the risk of recurrence and in determining the optimal surgical technique to reduce the risk of postoperative recurrence. As such, the importance of accurate quantification and localization of bone loss on preoperative imaging cannot be overstated. Although radiographs allow for a crude approximation, 3D CT represents the benchmark for assessing glenohumeral bone loss. More recently, 3D MRI has shown accuracy and reproducibility similar to that of 3D CT while also allowing for improved visualization of soft-tissue structures, but limited access and high costs have precluded its widespread adoption.