OrthoEvidence ACE Reports
Summarized ACE-level literature from OrthoEvidence to inform treatment decisions in shoulder instability and glenoid bone loss. Separate from the GlenometriX validation study.
Latarjet procedure demonstrates significantly lower recurrence rates vs. Bankart repair at 5-year follow-up in patients with bone loss > 13.5%. ISIS score ≥ 7 is a strong predictor of Bankart failure.
Off-track Hill-Sachs lesions are associated with a 4× higher recurrence rate post-Bankart repair. Glenoid track assessment is essential in all patients with prior dislocation.
A 20% glenoid bone loss threshold is consistently supported across high-quality trials as the point at which soft-tissue repair failure rates exceed 50%. Bone block procedures are indicated beyond this threshold.
The ISIS score remains a validated, reproducible risk stratification tool. Scores ≥ 7 correlate with ≥ 60% failure rate for isolated Bankart repair regardless of bone loss percentage.
Combined Bankart + remplissage in off-track lesions with bone loss < 20% achieves outcomes comparable to Latarjet at 2 years, with lower complication rates in select patients.
