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Open posterior stabilization for recurrent posterior glenohumeral instability
Brian R Wolf1, Sabrina Strickland, Riley J Williams
1Sports Medicine and Shoulder Service, Hospital for Special Surgery, Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. brian-wolf@uiowa.edu
Journal of Shoulder and Elbow Surgery
|March 25, 2005
Summary
Open posterior capsular shift effectively treats posterior glenohumeral instability. While 19% experienced recurrence, 84% of patients were satisfied, with no signs of arthritis developing post-surgery.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Instability
Background:
- Posterior glenohumeral instability often requires surgical intervention after nonoperative treatment failure.
- Limited long-term outcome data exists for open posterior stabilization procedures.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of open posterior capsular shift for posterior shoulder instability.
- To identify preoperative and intraoperative factors influencing surgical results.
Main Methods:
- A consecutive series of 48 primary open posterior capsular shifts were reviewed.
- Follow-up ranged from 1.8 to 22.5 years, with assessments including validated shoulder outcome scores (L'Insalata, SF-36) and physical/radiographic examinations.
- Preoperative and intraoperative factors were analyzed for their impact on outcomes.
Main Results:
- A recurrence of posterior instability was observed in 19% of shoulders.
- 84% of patients reported satisfaction with their shoulder's status.
- Poorer outcomes were associated with chondral defects and patient age over 37 at surgery.
- No progressive glenohumeral arthritis was evident radiographically up to 22 years post-surgery.
Conclusions:
- Open posterior shoulder stabilization is a reliable procedure for significant posterior instability.
- The procedure does not appear to induce arthritic changes in the glenohumeral joint.
- Chondral damage and older patient age are negative prognostic indicators for surgical success.