Iliac bone-block autograft for posterior shoulder instability.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Skeletal Reconstruction

Background:

• Posterior shoulder instability is rare, accounting for 4% of all shoulder instabilities.
• Surgical intervention is considered when conservative treatments fail.
• This study evaluates the posterior iliac bone-block procedure for recurrent posterior shoulder instability.

Purpose of the Study:

• To assess the clinical outcomes and imaging results of the posterior iliac bone-block procedure for recurrent posterior shoulder instability.
• To evaluate the efficacy and safety of this surgical technique.

Main Methods:

• Retrospective analysis of 8 patients with recurrent posterior shoulder instability treated with a posterior iliac bone-block.
• Surgical technique involved posterior deltoid detachment, infraspinatus dissociation, and bone-block placement to augment the glenoid.
• Clinical assessment and imaging (X-ray or CT) were used for evaluation.

Main Results:

• No postoperative suprascapular nerve deficits were observed.
• Patients regained normal range of motion in abduction and anterior elevation; external rotation was limited in 3 patients.
• Mean Constant score was 96.25, mean Duplay score was 90; 80% of cases showed satisfactory results at a mean 3-year follow-up.
• No bone-block pseudoarthrosis, osteolysis, or early degenerative changes were noted on imaging.
• No recurrences of instability were reported.

Conclusions:

• The posterior iliac bone-block is an effective treatment for posterior shoulder instability, offering good functional recovery and pain relief.
• The primary challenges involve accurate bone-block positioning and screw orientation.
• The technique demonstrates stabilizing efficacy with minimal risk of subsequent arthritic changes.