Mid-term clinical results of an arthroscopic glenoid rim reconstruction technique for recurrent anterior shoulder instability

Arch Orthop Trauma Surg. 2018 Nov;138(11):1557-1562. doi: 10.1007/s00402-018-2964-3. Epub 2018 Jun 11.

Abstract

Introduction: Glenoid bone loss in recurrent anterior instability of the shoulder needs to be addressed to restore joint stability. Over the last years, several arthroscopic methods have been described to treat this condition. However, no clinical mid-term results have been presented for arthroscopic iliac crest bone grafting procedures.

Methods: We included 32 patients with significant glenoid bone loss and repetitive dislocations of the shoulder who were treated in our shoulder unit with a previously described all-arthroscopic reconstruction technique. All patients filled out a questionnaire evaluating repetitive dislocations, consumption of pain medicine, Constant Score (CS, adapted to age and gender), activities of daily living (ADL), visual analogue scale for pain (VAS) as well as the Western Ontario Shoulder Instability Index (WOSI). Additionally, all complications were recorded.

Results: After a mean follow-up of 42 months, three traumatic dislocations had been observed. With an ADL of 25 points (95% CI 24-27), a WOSI of 71% (95% CI 65-76) and CS of 87 points (95% CI 82-92), our patients showed good functional results. The VAS result for pain was 2.1 (95% CI 1.5-2.6). No patient reported the regular usage of pain medicine related to the shoulder instability at final follow-up.

Conclusion: The all-arthroscopic glenoid reconstruction using iliac crest grafts shows good functional results with a recurrence rate of 9%. At final follow-up 42 months after surgery, our patients showed low pain levels and acceptable complications.

Keywords: Arthroscopic stabilization; Autologous bone graft; Glenoid deficit; Iliac crest; Recurrent shoulder instability; Shoulder arthroscopy.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Arthroscopy / adverse effects
  • Arthroscopy / methods*
  • Bone Transplantation / adverse effects
  • Bone Transplantation / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Ilium / transplantation
  • Joint Instability / surgery
  • Male
  • Middle Aged
  • Pain Measurement
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / epidemiology
  • Recurrence
  • Scapula / surgery
  • Shoulder Dislocation / surgery*
  • Shoulder Joint / surgery*
  • Treatment Outcome
  • Young Adult