Boytchev's Procedure with Bone Graft to the Glenoid Rim

From 1979, we performed Boytchev's procedure for treatment of reccurent anterior shoulder dislocation. A hundred of 113 shoulders which were treated by Boytchev's procedure were assesed. The resluts of this follow up study show that inferior instability of the gleno-humeral joint, hypoplasy of the subscapularis, large postero-lateral notch, bony defect of the glenoid rim were factors associated with less optimal results. Inferior instability of the gleno-humeral joint and small bony defects of the glenoid rim can be treated by prescribing rotator cuff exerecises. But cosideration should be given to whether bone grafts are needed for large defects of the glenoid rim using Boytchev's procedure. A defect of more than 20% the glenoid rim on axial view of the gleno-humeral joint indicated bone graft, a 10-20% defect was a relative indication for bone graft, and a defect of less than 10% of the glenoid rim indicated that a bone graft to the glenoid rim was not necessary.