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Letters to the Editor to:

Scientific Articles:
William H. Montgomery, Jr., Melvin Wahl, Carolyn Hettrich, Eiji Itoi, Steven B. Lippitt, and Frederick A. Matsen, III
Anteroinferior Bone-Grafting Can Restore Stability in Osseous Glenoid Defects
J Bone Joint Surg Am 2005; 87: 1972-1977 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read Letter to the Editor] Dr. Matsen replies to Dr. Barchilon & Dr. Meir
Frederick A. Matsen III, M.D.   (14 February 2006)
[Read Letter to the Editor] Location of the glenoid defect in recurrent anterior dislocations of the shoulder
Vidal S. Barchilon, Nyska Meir   (9 February 2006)

Dr. Matsen replies to Dr. Barchilon & Dr. Meir 14 February 2006
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Frederick A. Matsen III, M.D.
Depts. of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA

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Re: Dr. Matsen replies to Dr. Barchilon & Dr. Meir

matsen{at}u.washington.edu Frederick A. Matsen III, M.D.

We concur with Drs. Barchilon and Meir that the actual defect in patients can range from vertical to oblique. In our cadaver study, we chose to emulate the lesion described by Itoi in JBJS.
Location of the glenoid defect in recurrent anterior dislocations of the shoulder 9 February 2006
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Vidal S. Barchilon,
Orthopaedic Surgeon
Sapir Medical Center, Kfar-Saba, ISRAEL,
Nyska Meir

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Re: Location of the glenoid defect in recurrent anterior dislocations of the shoulder

vidalbar{at}zahav.net.il Vidal S. Barchilon, et al.

To The Editor:

We read with interest the article by Montgomery et al, "Anteroinferior Bone-Grafting Can Restore Stability in Osseous Glenoid Defects." We would like to draw attention to the fact that the defect size was created along a line inclined 45° from the centerline to the anteroinferior border of the glenoid with the apex at the 4:30 or 7:30 position, as suggested by Itoi, et al. (1)

The glenoid defect is located almost anterior to the glenoid in patients with recurrent anterior dislocations of the shoulder. The mean orientation of the defect pointing toward 3:01 on the clock face of the glenoid, at a mean angle of 90.5° ± 10.4° from the 12-o'clock direction, as decribed by Saito, et al. (2)

The model described by Itoi may need to be updated as it does not reflect the actual pathological anatomy of the glenoid in patients with recurrent anterior dislocations of the shoulder.

References:

1. Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am. 2000; 82:35-46.

2. Saito H, , Itoi E, Sugaya H, Minagawa H, Yamamoto N, Tuoheti Y, The American Journal of Sports Medicine, Vol. 33, No.Vol. 33, No. 6, 2005 Location of the Glenoid Defect in Shoulders With Recurrent Anterior Dislocation Hidetomo