Indications and outcomes of glenoid osteotomy for posterior shoulder instability: a systematic review

2021 ◽  
pp. 175857322110560
Author(s):  
Huda Sardar ◽  
Sandra Lee ◽  
Nolan S. Horner ◽  
Latifah AlMana ◽  
Peter Lapner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Cochrane Central Register ◽  
Posterior Shoulder Instability ◽  
Glenoid Version ◽  
Post Surgery ◽  
Posterior Shoulder ◽  
The Mean ◽  
Persistent Instability ◽  
Glenoid Retroversion

Background There is limited evidence examining glenoid osteotomy as a treatment for posterior shoulder instability. Methods A search of Medline, Embase, PubMed and Cochrane Central Register of Controlled Trials was conducted from the date of origin to 28th November 2019. Nine out of 3,408 retrieved studies met the inclusion criteria and quality was assessed using the Methodological Index for Non-randomized Studies tool. Results In 356 shoulders, the main indication for osteotomy was excessive glenoid retroversion (greater than or equal to approximately −10°). The mean preoperative glenoid version was −15° (range, −35° to −5°). Post-operatively, the mean glenoid version was −6° (range, −28° to 13°) and an average correction of 10° (range, −1° to 30°) was observed. Range of motion increased significantly in most studies and all standardized outcome scores (Rowe, Constant–Murley, Oxford instability, Japan Shoulder Society Shoulder Instability Scoring and mean shoulder value) improved significantly with high rates of patient satisfaction (85%). A high complication rate (34%, n = 120) was reported post-surgery, with frequent cases of persistent instability (20%, n = 68) and fractures (e.g., glenoid neck and acromion) (4%, n = 12). However, the revision rate was low (0.6%, n = 2). Conclusion Glenoid osteotomy is an appropriate treatment for posterior shoulder instability secondary to excessive glenoid retroversion. However, the high rate of persistent instability should be considered when making treatment decisions. Level of Evidence: Systematic review; Level 4

scholarly journals Differences in Outcomes Between Anterior and Posterior Shoulder Instability After Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110064
Author(s):  
Matthew L. Vopat ◽  
Reed G. Coda ◽  
Nick E. Giusti ◽  
Jordan Baker ◽  
Armin Tarakemeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Anterior Shoulder Instability ◽  
Posterior Shoulder Instability ◽  
Anterior Instability ◽  
Posterior Instability ◽  
Female Patients ◽  
Posterior Shoulder ◽  
Male Patients ◽  
Postoperative Instability

Background: The glenohumeral joint is one of the most frequently dislocated joints in the body, particularly in young, active adults. Purpose: To conduct a systematic review and meta-analysis to evaluate and compare outcomes between anterior versus posterior shoulder instability. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using the PubMed, Cochrane Library, and MEDLINE databases (from inception to September 2019) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were published in the English language, contained outcomes after anterior or posterior shoulder instability, had at least 1 year of follow-up, and included arthroscopic soft tissue labral repair of either anterior or posterior instability. Outcomes including return-to-sport (RTS) rate, postoperative instability rate, and pre- and postoperative American Shoulder and Elbow Surgeons (ASES) scores were recorded and analyzed. Results: Overall, 39 studies were included (2077 patients; 1716 male patients and 361 female patients). Patients with anterior instability had a mean age of 23.45 ± 5.40 years (range, 11-72 years), while patients with posterior instability had a mean age of 23.08 ± 8.41 years (range, 13-61 years). The percentage of male patients with anterior instability was significantly higher than that of female patients (odds ratio [OR], 1.36; 95% CI, 1.04-1.77; P = .021). Compared with patients with posterior instability, those with anterior instability were significantly more likely to RTS (OR, 2.31; 95% CI, 1.76-3.04; P < .001), and they were significantly more likely to have postoperative instability (OR, 1.53; 95% CI, 1.07-2.23; P = .018). Patients with anterior instability also had significantly higher ASES scores than those with posterior instability (difference in means, 6.74; 95% CI, 4.71-8.77; P < .001). There were no significant differences found in postoperative complications between the anterior group (11 complications; 1.8%) and the posterior group (3 complications; 1.6%) (OR, 1.12; 95% CI, 0.29-6.30; P = .999). Conclusion: Patients with anterior shoulder instability had higher RTS rates but were more likely to have postoperative instability compared with posterior instability patients. Overall, male patients were significantly more likely to have anterior shoulder instability, while female patients were significantly more likely to have posterior shoulder instability.

Posterior shoulder instability: a systematic review

2020 ◽  
Vol 134 (1) ◽  
pp. 34-53
Author(s):  
Umile Giuseppe Longo ◽  
Mauro Ciuffreda ◽  
Joel Locher ◽  
Carlo Casciaro ◽  
Nicholas Mannering ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Shoulder Instability ◽  
Optimal Treatment ◽  
Treatment Modalities ◽  
Posterior Shoulder Instability ◽  
Posterior Instability ◽  
Posterior Shoulder ◽  
Comprehensive Search ◽  
Tissue Abnormalities

Abstract Introduction This review aims to provide information on outcomes of surgical procedures for soft tissue or bony glenoid and/or humeral abnormalities in case of posterior shoulder instability. Source of data A systematic review of the literature according to the PRISMA guidelines was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, Ovid and Google Scholar databases using various combinations of the keywords ‘shoulder’, ‘posterior instability’, ‘dislocation’, ‘reversed bony bankart’, ‘reversed Hill Sachs’, and ‘capsulolabral’ was performed. Areas of agreement A total of 847 shoulders in 810 patients were included. A redislocation event occurred in 33 (8.7%) of 411 shoulders with soft tissue abnormalities and in 12 (9.1%) of 132 shoulders with bony abnormalities of the glenoid, humeral head or both. Areas of controversy The optimal treatment modalities for posterior shoulder dislocation remain to be defined. Growing points Operative stabilization for posterior shoulder instability should be lesion-specific and should correct all components of the posterior instability. Areas timely for developing research Future prospective studies should aim to establish the optimal treatment modalities for posterior shoulder instability.

Glenoid osteotomy in young patients with glenoid retroversion and posterior shoulder instability

2018 ◽  
Vol 34 (2) ◽  
pp. 202
Author(s):  
L. Lacheta ◽  
T. Singh ◽  
J.-M. Hovsepian ◽  
S. Braun ◽  
A. Imhoff ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Young Patients ◽  
Posterior Shoulder Instability ◽  
Posterior Shoulder ◽  
Glenoid Retroversion

scholarly journals Location of the Glenoid Defect in Shoulders with Recurrent Posterior Glenohumeral Instability

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0037
Author(s):  
Matthew Provencher ◽  
Liam Peebles ◽  
Brandon Goldenberg ◽  
Peter Millett ◽  
Travis Dekker
Keyword(s):  
Bone Loss ◽  
Bone Defect ◽  
Shoulder Instability ◽  
Bone Defects ◽  
Posterior Shoulder Instability ◽  
Glenoid Defect ◽  
Face Model ◽  
Posterior Shoulder ◽  
Text Figure ◽  
The Mean

Objectives: Posterior glenoid bone deficiency is an increasingly recognized entity in the setting of recurrent posterior shoulder instability; however, little is known about the subject. Due to the paucity of literature on posterior bone loss, historical comparisons to anterior bone loss may not be fully accurate. The purpose of this study was to systematically describe the morphology of posterior bone defects in the setting of recurrent posterior shoulder instability based on several quantitative parameters, including the mean location, orientation, and extent of bone loss on a clock face model, as well as the angle of the defect relative to the long axis of the glenoid. Methods: 3-dimensional (3D) reconstructed computed tomography (CT) scans of serially collected patients with a history of recurrent posterior shoulder instability were evaluated by three separate reviewers. The posterior glenoid bone defect was characterized using the following measures: (a) the mean lesion location and orientation based on a clock face model with 6:00 o’clock denoted as inferior and 9:00 o’clock as directly posterior for all patients; (b) the total extent of the posterior bone defect based on the clock face; and (c) the average angle of the bone loss relative to the long axis of the glenoid. Results: A total of 70 male patients and 1 female patient with mean age of 29.3 years (range = 24.4 to 35.1 years) were included in the analysis. The mean clock face location of the posterior glenoid defect originated at 6:44 (range = 4:16 to 8:12) and extended to a mean of 9:28 (range = 7:02 to 10:38). The mean extent of the posterior glenoid defect was 2:43 (range = 1:08 to 4:50), which corresponds to a mean total bone loss arc of 81.5° (range = 34.2° to 144.9°), nearly one quadrant of the glenoid. Posterior bone loss occurred in a posteroinferior direction at a mean angle of 30.7° (range = 8.0° to 80.0°) relative to the long axis of the glenoid. Conclusion: This study describes the location and orientation of posterior glenoid bone loss one can expect when treating this challenging patient population. Posterior bone defects in the setting of posterior shoulder instability most commonly occur in the posterior-inferior quadrant of the glenoid and extend on average from 6:44 to 9:28 (81.5° total degrees of arc) on a clock face model. Posterior bone loss occurs at a mean of 30° off the long axis of the glenoid in a posteroinferior direction, which is historically different from anterior bone loss, which occurs parallel to the long axis of the glenoid. This study serves to highlight the location and orientation of bone loss that one can expect in a patient with recurrent posterior shoulder instability, although additional work is needed to assess why this develops. [Figure: see text][Figure: see text][Figure: see text][Figure: see text]

Posterior Glenoid Bone-Block Transfer for Posterior Shoulder Instability – A Systematic Review

2021 ◽  
Author(s):  
Edward S. Mojica ◽  
Luke B. Schwartz ◽  
Eoghan T. Hurley ◽  
Guillem Gonzalez-Lomas ◽  
Kirk A. Campbell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Bone Block ◽  
Posterior Shoulder Instability ◽  
Posterior Shoulder ◽  
Block Transfer
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