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Absolute Indications for Open Surgery

Absolute indications for open stabilization procedures include significant degrees of glenoid or humeral bone loss, capsular deficiencies, or irreparable rotator cuff tears, particularly those of the subscapularis. In individuals with significant anterior glenoid erosion, an osseous reconstruction should be performed.

In the rare case where a large humeral head defect (Hill-Sachs lesion) plays a role in the recurrence of instability, open surgery is performed. More commonly, however, when there is a large Hill Sachs defect, anterior glenoid bone loss plays the critical role in instability. When there is a chronic disruption of the subscapularis, usually in the setting of prior surgery, an open repair is performed.

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