Recurrent posterior instability of the shoulder

Seven cases of recurrent posterior instability of the shoulder were reviewed, three with recurrent subluxation and four with recurrent posterior dislocations. All were treated surgically, one by inverted Putti-Platt, one by glenoplasty and five by posterior bone block procedures. The follow-up goes from three to 17.5 years (mean 8.5 years). Clinical history and physical examination were the most accurate diagnostic methods. There were three excellent, one fair, and one poor results with two failures. The poor result and failure cases are due to technical errors, particularly because of wrong positioning of the graft in posterior bone block procedures. We suggest a bone graft with a projection of at least 15 mm beyond the glenoid rim to obtain a good result with this technique. Osteoarthritis does not seem to develop at long-term in our patients even with a poor result except for those with iatrogenic origin. The functional results are stable over time except for patients with osteoarthritis.