Skip to main content
Log in

Posterior bone block procedure for posterior shoulder instability

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The posterior bone block procedure is an uncommon surgical procedure used in the treatment of posterior shoulder instability. The purpose of this study is to report the results of the posterior bone block procedure in the treatment of posterior shoulder instability. We retrospectively reviewed 21 shoulders that had undergone a posterior bone block procedure in the treatment of recurrent posterior shoulder instability between 1984 and 2001. Fifteen patients (16 shoulders) had a prior traumatic posterior glenohumeral dislocation and 5 patients (5 shoulders) had a prior traumatic posterior glenohumeral subluxation. The mean age at surgery was 24.8 years (range 17–40 years). Patients were evaluated with the Constant score, the Duplay score, a subjective result, and radiography. Preoperatively, ten shoulders had glenoid fractures, two shoulders had loss of the normal contour of the posterior osseous glenoid, and ten shoulders had humeral head impaction fractures (reverse Hill-Sachs lesion). Seventeen shoulders underwent preoperative computed tomography and had average glenoid retroversion of 9.6° (range 0–21°). At an average follow-up of 6 years, all patients reported their subjective results as good or excellent. At follow-up the mean Constant score was 93.3 points (range 80–103 points), and the mean Duplay score was 85.6 points (range 40–100 points). Fifteen patients returned to sports at their pre-injury level. Three patients were considered clinical failures; one with a recurrent posterior dislocation and two with substantial posterior apprehension on follow-up examination. Two shoulders had glenohumeral arthritis on radiographs at the latest follow-up. The posterior bone block is a good treatment option for posterior dislocation. The risk of recurrent dislocation is low following this procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Abrams JS, Savoie FH III, Tauro JC et al (2002) Recent advances in the evaluation and treatment of shoulder instability: anterior, posterior, and multidirectional. Arthroscopy 18:1–13

    PubMed  Google Scholar 

  2. Ahlgren SA, Hedlund T, Nistor L (1978) Idiopathic posterior instability of the shoulder joint. Results of operation with posterior bone graft. Acta Orthop Scand 49:600–603

    Article  PubMed  CAS  Google Scholar 

  3. Bernageau J, Patte D, Debeyre J et al (1976) Interet du profil glenoidien dans les luxations recidivantes de l’epaule. Rev Chir Orthop Reparatrice Appar Mot 62(Suppl 2):142–147

    PubMed  CAS  Google Scholar 

  4. Brewer BJ, Wubben RC, Carrera GF (1986) Excessive retroversion of the glenoid cavity. A cause of non-traumatic posterior instability of the shoulder. J Bone Joint Surg Am 68:724–731

    PubMed  CAS  Google Scholar 

  5. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  6. Djian P, Christel P, Herman S et al (1997) Traitement chirurgical des instabilités postérieures d’épaule par ostéotomie d’antéversion du col de l’omoplate associée à une capsulorraphie postérieure. J Traumatol Sport 14:137–146

    Google Scholar 

  7. Edwards TB, Boulahia A, Walch G (2003) Radiographic analysis of bone defects in chronic anterior shoulder instability. Arthroscopy 19:732–739

    Article  PubMed  Google Scholar 

  8. Essadki B, Dumontier C, Sautet A et al (2000) Instabilite posterieure de l’epaule chez le sportif traitee par butee iliaque. A propos de 6 observations. Rev Chir Orthop Reparatrice Appar Mot 86:765–772

    PubMed  CAS  Google Scholar 

  9. Fronek J, Warren RF, Bowen M (1989) Posterior subluxation of the glenohumeral joint. J Bone Joint Surg Am 71:205–216

    PubMed  CAS  Google Scholar 

  10. Fuchs B, Jost B, Gerber C (2000) Posterior-inferior capsular shift for the treatment of recurrent, voluntary posterior subluxation of the shoulder. J Bone Joint Surg Am 82:16–25

    PubMed  CAS  Google Scholar 

  11. Gerber C, Ganz R, Vinh TS (1987) Glenoplasty for recurrent posterior shoulder instability. An anatomic reappraisal. Clin Orthop Relat Res 216:70–79

    PubMed  Google Scholar 

  12. Gosens T, van Biezen FC, Verhaar JA (2001) The bone block procedure in recurrent posterior shoulder instability. Acta Orthop Belg 67:116–120

    PubMed  CAS  Google Scholar 

  13. Goutallier D, Piat C, Postel JM et al (1995) Les butées rétro-glènoidiennes dans le traitement des instabilités postérieures récidivantes de l’épaule non traumatique. Rev Chir Orthop Reparatrice Appar Mot 81(Suppl 2):154–155

    Google Scholar 

  14. Heller KD, Forst J, Cohen B et al (1995) Atraumatic recurrent posterior shoulder subluxation: review of the literature and recommendations for treatment. Acta Orthop Belg 61:263–270

    PubMed  CAS  Google Scholar 

  15. Hurley JA, Anderson TE, Dear W et al (1992) Posterior shoulder instability. Surgical versus conservative results with evaluation of glenoid version. Am J Sports Med 20:396–400

    Article  PubMed  CAS  Google Scholar 

  16. Johnston GH, Hawkins RJ, Haddad R et al (1984) A complication of posterior glenoid osteotomy for recurrent posterior shoulder instability. Clin Orthop Relat Res 187:147–149

    PubMed  Google Scholar 

  17. Jones V (1958) Recurrent posterior dislocation of the shoulder: report of a case treated by posterior bone block. J Bone Joint Surg Br 40:203–207

    PubMed  Google Scholar 

  18. Kim SH, Ha KI, Park JH et al (2003) Arthroscopic posterior labral repair and capsular shift for traumatic unidirectional recurrent posterior subluxation of the shoulder. J Bone Joint Surg Am 85-A:1479–1487

    PubMed  Google Scholar 

  19. Kouvalchouk JF, Coudert X, Watin Augouard L et al (1993) Le traitement des instabilites posterieures de l’epaule par butee acromiale pediculee a un lambeau deltoidien. Rev Chir Orthop Reparatrice Appar Mot 79:661–665

    PubMed  CAS  Google Scholar 

  20. Levigne C, Boileau P, Walch G (1995) Les luxations traumatiques de l’épaule - a propos d’une série de 37 épaules. In: Gazielly D, Duparc F, Levigne C (eds) Monographie du Groupe d’Etude de l’Epaule et du Coude, Edition Les Luxations Postérieures traumatiques de l’épaule. Sauramps Médical, Montpellier, pp 68–73

    Google Scholar 

  21. Levigne C, Garret J, Walch G (2005) Posterior bone block for posterior instability. Techn Shoulder Elbow Surg 6:26–35

    Google Scholar 

  22. Levigne C, Walch G (1998) Osteotomy and bone block techniques for posterior glenohumeral instability. In: Fu FH, Ticker JB, Imhoff AB (eds) An atlas of shoulder surgery. Martin Dunitz, London, pp 47–56

    Google Scholar 

  23. McIntyre LF, Caspari RB, Savoie FH III (1997) The arthroscopic treatment of posterior shoulder instability: two-year results of a multiple suture technique. Arthroscopy 13:426–432

    Article  PubMed  CAS  Google Scholar 

  24. McLaughlin HL (1952) Posterior dislocation of the shoulder. J Bone Joint Surg Am 34:584

    Google Scholar 

  25. Mowery CA, Garfin SR, Booth RE et al (1985) Recurrent posterior dislocation of the shoulder: treatment using a bone block. J Bone Joint Surg Am 67:777–781

    PubMed  CAS  Google Scholar 

  26. Robinson CM, Aderinto J (2005) Recurrent posterior shoulder instability. J Bone Joint Surg Am 87:883–892

    Article  PubMed  Google Scholar 

  27. Samilson RL, Prieto V (1983) Dislocation arthropathy of the shoulder. J Bone Joint Surg Am 65:456–460

    PubMed  CAS  Google Scholar 

  28. Sirveaux F, Leroux J, Roche O et al (2004) Traitement de l’instabilite posterieure de l’epaule par butee iliaque ou acromiale: a propos d’une serie de 18 cas. Rev Chir Orthop Reparatrice Appar Mot 90:411–419

    PubMed  CAS  Google Scholar 

  29. Surin V, Bläder S, Markhede G et al (1990) Rotational osteotomy of the humerus for posterior instability of the shoulder. J Bone Joint Surg Am 72:181–186

    PubMed  CAS  Google Scholar 

  30. Walch G (1991) la Luxation récidivante antérieure de l’épaule. Rev Chir Orthop Reparatrice Appar Mot 77(Suppl 1):117–190

    Google Scholar 

  31. Walch G, Boileau P (1991) Instabilités et luxations de l’épaule. Editions Techniques, Encycl Med Chir (Paris, France), Appareil Locomoteur:14-037-A-10

  32. Walch G, Dejour H, Trillat A (1988) Recurrent anterior dislocation of the shoulder with onset after the age of forty years. French J Orthop Surg 1:19–26

    Google Scholar 

  33. Williams RJ III, Strickland S, Cohen M et al (2003) Arthroscopic repair for traumatic posterior shoulder instability. Am J Sports Med 31:203–209

    PubMed  Google Scholar 

  34. Wolf EM, Eakin CL (1998) Arthroscopic capsular plication for posterior shoulder instability. Arthroscopy 14:153–163

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elvire Servien.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Servien, E., Walch, G., Cortes, Z.E. et al. Posterior bone block procedure for posterior shoulder instability. Knee Surg Sports Traumatol Arthr 15, 1130–1136 (2007). https://doi.org/10.1007/s00167-007-0316-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-007-0316-x

Keywords

Navigation