University of Michigan Health System

Department of Orthopaedic Surgery

Cancer Center Trials

Research looks into shoulder instability

Bone defects and shoulder instability is a very difficult clinical problem to manage. These defects have been linked to a high rate of recurrent dislocation even following surgical repair and, ultimately, chronic pain, arthritis, loss of motion, and inability for the patient to return to previous activities. Despite this, they often go undiagnosed, and even when recognized there are limited options available.

Management of shoulder instability and bony defects of the glenohumeral joint has been a major area of clinical and research focus for Dr. Jon K. Sekiya, Associate Professor in the Sports Medicine Service in the Department of Orthopaedic Surgery at the University of Michigan. He and his colleague from the University of Pittsburgh, Dr. Richard Debski, recently finished work that may lead to breakthroughs in treatment of bony defects in the shoulder.

Their work on osteoarticular allograft (OA) transplantation of humeral head defects was funded by the Orthopaedic Research and Education Foundation. They used state-of-the-art robotic technology to biomechanically assess the effects of bony defects on shoulder function and determine how well anatomic reconstructive techniques restore joint function. They found that instability increases as the size of the lesion increases but can be restored to normal with OA transplantation. In Dr. Sekiya’s practice, he has revised many patients sent in with previous failed instability surgery with OA transplantation with great success. Many have had as many as 2 to 4 failed surgical attempts with recurrent instability before undergoing OA transplantation.

The development of improved treatment options for bone defects after shoulder dislocation may lead to improved quality of life for patients who experience this difficult problem.