Prevention and management of post-instability glenohumeral arthropathy

Figure 1 Anteroposterior (A) and lateral (B) X-rays of a 39-year-old male with dislocation arthropathy status post instability procedure with metal anchors.

Figure 2 Flow-chart demonstrating decision algorithm for non-prosthetic cartilage treatment options.

Figure 3 Flow-chart depicting treatment options after loss of glenohumeral kinematics.

Figure 4 Flow-chart demonstrating decision algorithm for non-prosthetic vs prosthetic treatment options that include arthroscopic and open procedures.

Figure 5 Comprehensive arthroscopy management of glenohumeral arthropathy. A: Images from a 37-year-old male with instability arthropathy demonstrating preoperative anteroposterior radiograph with large inferior humeral head osteophyte and loss of glenohumeral joint space; B: Intra-operative fluoroscopy localization of extent of inferior humeral head osteophyte; C: Intra-operative arthroscopic image viewing from posterior portal, demonstrating inferior humeral neck (a) status post debridement of osteophyte, the arthroscopic shaver is on the inferior capsule; D: Post-operative anteroposterior radiograph demonstrating debridement of osteophyte and biceps tenodesis with a biocomposite screw.

Figure 6 Fresh osteochondral allograft transplantation. A: Intra-operative arthroscopic image of central humeral articular lesion while viewing from a posterior portal in a 39-year-old patient; B: After an open approach, preparation of the central lesion; C: Harvesting a corresponding osteochondral plug from a size-matched, fresh allograft humerus; D: Status post insertion of the osteochondral plug into the defect.