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Glenoid Bone Loss

Glenoid bone loss refers to the loss of bone from the front of the shoulder socket (glenoid). It commonly develops after recurrent anterior shoulder dislocations and can make the shoulder increasingly unstable over time.

Small amounts of bone loss may not require specific treatment. However, more significant bone loss can increase the risk of further dislocations and influence the choice of surgery.

Understanding whether glenoid bone loss is present is an important part of planning treatment for shoulder instability.

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What is the Glenoid?

The glenoid is the shallow socket of the shoulder joint.

Together with the humeral head (the ball), it forms the shoulder’s ball-and-socket joint.

Although the socket is naturally shallow to allow a wide range of movement, its shape is important for maintaining stability.

Each shoulder dislocation has the potential to damage not only the soft tissues, such as the labrum, but also the bone of the glenoid.

As more bone is lost, the shoulder becomes less stable and may dislocate more easily.

What Causes Glenoid Bone Loss?

The most common cause is recurrent anterior shoulder dislocation.

Bone loss may occur:

• During the first traumatic dislocation
• Following repeated dislocations
• After recurrent shoulder subluxations
• Occasionally after failed previous shoulder stabilisation surgery

Contact athletes are at higher risk because repeated instability episodes may progressively enlarge the defect.

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Symptoms

Glenoid bone loss itself does not usually cause pain.

Instead, patients often experience symptoms related to shoulder instability, including:

• Recurrent shoulder dislocations
• Shoulder slipping out of place
• Apprehension during overhead activities
• Loss of confidence during sport
• Difficulty returning to contact sports

The underlying instability is usually more noticeable than the bone loss itself.

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Why is Glenoid Bone Loss Important?

The amount of bone loss can influence the success of surgery.

For example:

• Small defects may still be treated successfully with arthroscopic Bankart repair.
• Larger defects increase the risk that the shoulder will dislocate again if only the labrum is repaired.
• In these situations, procedures that restore the bone, such as a Latarjet procedure, may provide a more stable shoulder.

Treatment is based on the overall pattern of instability rather than bone loss alone.

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Associated Injuries

Glenoid bone loss commonly occurs together with:

• Bankart tear
• Hill-Sachs lesion
• Shoulder instability
• Shoulder dislocation

These injuries are assessed together when planning treatment.

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How is Glenoid Bone Loss Diagnosed?

Diagnosis begins with a clinical assessment.

Your orthopaedic surgeon will ask about:

• Previous dislocations
• Number of instability episodes
• Sporting activities
• Previous shoulder surgery

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Imaging

X-rays

X-rays may suggest bone loss but often underestimate its size.

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CT Scan

CT is the most accurate investigation for measuring glenoid bone loss.

Three-dimensional CT imaging is particularly useful when surgery is being considered.

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MRI

MRI provides information about:

• Labral tears
• Rotator cuff injuries
• Cartilage
• Associated Hill-Sachs lesions

Although MRI may demonstrate bone loss, CT usually provides more accurate measurements.

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Does Every Patient Need Surgery?

No.

Many patients with mild bone loss and a stable shoulder can be treated successfully without surgery.

The decision depends on:

• Shoulder stability
• Frequency of dislocations
• Activity level
• Sporting demands
• Associated injuries

Treatment is individualised rather than based on imaging alone.

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When is Surgery Recommended?

Surgery may be considered if there is:

• Recurrent instability
• Significant glenoid bone loss
• Failed previous stabilisation surgery
• High-risk contact sports
• Associated Bankart tear
• Engaging Hill-Sachs lesion

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Surgical Treatment

The most appropriate procedure depends on the overall injury pattern.

Options may include:

Arthroscopic Bankart Repair

Suitable for many patients without significant bone loss.

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Latarjet Procedure

The Latarjet procedure transfers a small piece of bone from the coracoid to the front of the glenoid, increasing the size of the socket and improving shoulder stability.

It is commonly recommended when bone loss is significant or when previous stabilisation surgery has failed.

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Other Bone Reconstruction Procedures

In selected patients with severe bone loss or complex revision surgery, other reconstructive techniques may be considered such as the Eden-Hybinette procedure using the iliac crest bone graft or the Glenoid Reconstruction with Distal Tibia Allograft (DTA) procedure.

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Recovery

Recovery depends on the procedure performed.

Typical recovery includes:

Activity	Approximate Time
Sling	3–6 weeks
Physiotherapy	Begins early
Office work	1–2 weeks
Driving	4–6 weeks
Strengthening	8–12 weeks
Return to contact sports	4–6 months

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Frequently Asked Questions

Can bone grow back by itself?

No. Bone that has been lost from the front of the glenoid does not usually regenerate on its own. Treatment focuses on restoring shoulder stability rather than replacing small amounts of bone loss.

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Why do I need a CT scan?

CT provides the most accurate assessment of the size and shape of the bone defect. This information helps determine which treatment is most appropriate.

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Does every patient with glenoid bone loss need a Latarjet procedure?

No. Many patients with smaller defects can be successfully treated without bone augmentation. The decision depends on the degree of bone loss, associated injuries and the overall pattern of shoulder instability.

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Is bone loss more important than a Bankart tear?

They are both important. A Bankart tear affects the soft tissues that stabilise the shoulder, while glenoid bone loss affects the shape of the socket itself. Both factors are considered together when planning treatment.

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Why Choose Dr Puah Ken Lee?

Dr Puah Ken Lee is an orthopaedic surgeon in Singapore whose practice focuses on shoulder, elbow and sports injuries. He has experience managing both soft tissue and bony causes of shoulder instability, including recurrent dislocations, labral tears and glenoid bone loss. Treatment is individualised based on your symptoms, imaging, activity level and long-term goals.

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Related Conditions

Shoulder instability

• Shoulder Instability
• Shoulder Dislocation
• Shoulder Labral Tear
• Bankart Tear
• Hill-Sachs Lesion
• Arthroscopic Latarjet

Other related pages

• Shoulder Instability Surgery
• Shoulder Surgery
• Sports Injuries
• Return to Sport After Injury
• First Orthopaedic Consultation

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For a full overview of shoulder conditions, visit Shoulder Specialist Singapore

Dr Puah is regularly invited to teach shoulder surgery internationally

Specialist Care for Shoulder Injuries in Singapore

Dr Puah is an orthopaedic surgeon specialising in shoulder, elbow and sports injuries. He provides personalised care tailored to each patient’s condition and activity level.

Consultations are available at Mount Elizabeth Novena.

If you are experiencing shoulder pain that is affecting your daily life or sports, early assessment can help guide appropriate treatment.

Book a consultation or contact the clinic to discuss your condition.

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Book a consultation at 360 Orthopaedics, Mount Elizabeth Novena

Shoulder instability is common but treatable. Early diagnosis and appropriate management can improve outcomes and prevent long-term problems.
Dr Puah Ken Lee is an orthopaedic surgeon in Singapore specialising in shoulder, elbow and sports injuries at 360 Orthopaedics, Mount Elizabeth Novena. Patients with persistent shoulder pain or instability are encouraged to seek specialist evaluation.