Our latest blog focuses on Dr Matthew Provencher, one of America’s leading orthopaedic surgeons, specialising in the surgical treatment and rehabilitation of injuries to the knee and shoulder.
Dr Provencher practices at The Steadman Clinic in Vail, Colorado, and conducts research as a Principal Investigator at the renowned Steadman Philippon Research Institute aimed at innovation and improvement in patient care in the field of orthopaedic sports medicine.
Shoulder instability with severe bone loss is challenging to treat, given that the bony foundation of the joint has been placed in jeopardy. In cases of severe bone loss, research has shown that soft tissue repair, including arthroscopic stabilization surgery, does not always reestablish shoulder stability. Instead, bone graft surgery has proven to be much more effective in these cases. A coracoid process graft, iliac crest autograft, and distal tibia allograft placed at the area of bone loss of the socket (glenoid bone) have been proven effective for treating severe bone loss.
Glenoid bone loss after a single dislocation has been found in up to 22% of patients and is a leading cause of arthroscopic instability repair failure. To determine the amount of the socket (glenoid bone) and bone loss of the ball (humeral head), Dr Provencher uses traditional imaging, including x-rays and the latest imaging technology, to acquire a 3-D CT scan. The amount and characteristics of the patient’s bone loss will be assessed through this imaging to arrive at an individualized and proven treatment method.
Then, to provide his patients with the most individualized treatment plan, Dr Provencher will also do a thorough physical examination of the injured shoulder aside from the acquired imaging. In general, arthroscopic techniques are commonly reserved for patients with bony defects of the shoulder joint. In contrast, open surgery techniques with the application of bone graft are reserved for cases of severe bone loss.
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