Recurrent posterior shoulder instability-Long-term results after arthroscopic posterior bone block with capsular reconstruction

被引：0
作者：
Karkosch, Roman F. [1 ]
Slapar, Juergen [1 ]
Smith, Tomas [1 ]
Wellmann, Mathias [2 ]
Pastor, Marc-Frederic [1 ,3 ]
Horstmann, Hauke [1 ]
机构：
[1] Hanover Med Sch MHH, Orthoped Surg Dept, Anna von Borries Str 1-7, D-30625 Hannover, Germany
[2] Orthhoprofis, Hannover, Germany
[3] Staedt Klinikum Braunschweig, Dept Orthoped & Trauma Surg, Braunschweig, Germany
来源：
JOURNAL OF EXPERIMENTAL ORTHOPAEDICS | 2025年 / 12卷 / 01期
关键词：
arthroscopic posterior bone block; capsular repair; posterior glenoid bone loss; posterior shoulder instability; STABILIZATION; DIAGNOSIS; REPAIR;
D O I：
10.1002/jeo2.70166
中图分类号：
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];
学科分类号：
摘要：
PurposeThis study reports the long-term post-operative clinical outcomes after arthroscopic posterior bone block augmentation with posterior capsular repair.MethodsEighteen shoulders (13 patients) with unidirectional posterior shoulder instability were treated with an arthroscopic posterior bone block augmentation and posterior capsular repair in 2011 and 2013 in a single specialized orthopaedic clinic. These patients were invited to participate in a clinical and radiological follow-up examination to receive long-term results regarding clinical outcomes, instability, and development of osteoarthritis (OA).ResultsFrom the initial study group, 13 patients (18 shoulders) could be obtained for a follow-up examination. The mean follow-up period was 111 months. At the final follow-up, two patients (two shoulders) reported recurrent subluxations with a positive apprehension sign. No redislocation was reported. Screw fixation was still in place in seven patients (38.9%). Overall, good clinical outcomes were achieved among Constant-Murley score (77.6 +/- 16; p = 0.55), Rowe score (67.5 +/- 22.1; p = 0.34), Walch-Duplay score (58.3 +/- 28.2) and Western Ontario Shoulder Index (40.4 +/- 23.3%; p = 0.96), showing insignificant changes compared with the 2-year results. Three shoulders developed severe OA (Samilson and Prieto III). No patient required arthroplasty.ConclusionArthroscopic posterior bone block augmentation with posterior capsular repair represents a salvage procedure that can achieve long-term shoulder stability with overall moderate clinical results. Patients have to be informed about the probable need for implant removal and the high risk of OA development, especially in the presence of pre-existing cartilage damage, beforehand.Level of EvidenceLevel IV.
引用
收藏
页数：7
相关论文
共 29 条
  • [1] Allain J., Goutallier D., Glorion C., Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder, J Bone Jt Surg, 80, pp. 841-852, (1998)
  • [2] Backer H.C., Galle S.E., Maniglio M., Rosenwasser M.P., Biomechanics of posterior shoulder instability—current knowledge and literature review, World J Orthop, 9, pp. 245-254, (2018)
  • [3] Barbier O., Ollat D., Marchaland J.P., Versier G., Iliac bone-block autograft for posterior shoulder instability, Orthop Traumatol Surg Res, 95, pp. 100-107, (2009)
  • [4] Billaud A, Baverel L, ReSurg SoFEC, Metais P, Arthroscopic Latarjet yields better union and prevention of instability compared to arthroscopic bony Bankart repair in shoulders with recurrent anterior instability: a systematic review, Knee Surg Sports Traumatol Arthrosc, 31, pp. 5994-6005, (2023)
  • [5] Bockmann B., Nebelung W., Groger F., Leuzinger J., Agneskirchner J., Brunner U., Et al., The arthroscopic treatment of anterior shoulder instability with glenoid bone loss shows similar clinical results after Latarjet procedure and iliac crest autograft transfer, Knee Surg Sports Traumatol Arthrosc, 31, pp. 4566-4574, (2023)
  • [6] Boileau P., Saliken D., Gendre P., Seeto B.L., d'Ollonne T., Gonzalez J.F., Et al., Arthroscopic latarjet: suture-button fixation is a safe and reliable alternative to screw fixation, Arthroscopy, 35, pp. 1050-1061, (2019)
  • [7] Bottoni C.R., Franks B.R., Moore J.H., DeBerardino T.M., Taylor D.C., Arciero R.A., Operative stabilization of posterior shoulder instability, Am J Sports Med, 33, pp. 996-1002, (2005)
  • [8] Bradley J.P., Baker C.L., Kline A.J., Armfield D.R., Chhabra A., Arthroscopic capsulolabral reconstruction for posterior instability of the shoulder: a prospective study of 100 shoulders, Am J Sports Med, 34, pp. 1061-1071, (2006)
  • [9] Camenzind R.S., Gossing L., Martin Becerra J., Ernstbrunner L., Serane-Fresnel J., Lafosse L., Restoration of the posterior glenoid in recurrent posterior shoulder instability using an arthroscopically placed iliac crest bone graft: a computed tomography-based analysis, Orthop J Sports Med, 9, (2021)
  • [10] Cognetti D.J., Hughes J.D., Kay J., Chasteen J., Fox M.A., Hartzler R.U., Et al., Bone block augmentation of the posterior glenoid for recurrent posterior shoulder instability is associated with high rates of clinical failure: a systematic review, Arthroscopy, 38, pp. 551-563.e555, (2022)
123