title: The modified Bristow procedure for anterior shoulder instability: 26-year outcomes in Naval Academy midshipmen.
abstract: BACKGROUND
  Many procedures have been proposed for the correction of anterior shoulder instability. Some of these procedures address the problem anatomically, such as the Bankart procedure, and some prevent instability nonanatomically, such as the Bristow-Latarjet procedure. A modified Bristow procedure was the procedure of choice for anterior shoulder instability among midshipmen at the United States Naval Academy from 1975 to 1979.
  
  
  OBJECTIVE
  The modified Bristow procedure for anterior shoulder instability provides good shoulder function and stability in the long term.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  There were 52 shoulders in 49 patients reviewed at a mean follow-up of 26.4 years. The Rowe score, Single Assessment Numeric Evaluation, and Western Ontario Shoulder Instability Index were used to assess outcomes.
  
  
  RESULTS
  The mean Rowe score was 81.8 (range, 5-100), and the mean Single Assessment Numeric Evaluation score was 82.9 (range, 30-100), with an overall Single Assessment Numeric Evaluation of 71.2% (37 of 52 shoulders) rated as good and excellent. The mean Western Ontario Shoulder Instability Index was 376 of 2100 (range, 0-1560). Overall, recurrent instability occurred in 8 of 52 shoulders (15.4%), with recurrent dislocation in 5 shoulders (9.6%) and recurrent subluxation in 3 shoulders (5.8%). The mean time to recurrent dislocation was 7.0 years.
  
  
  CONCLUSIONS
  This study represents the longest follow-up in the literature of the modified Bristow procedure. The authors have shown nearly 70% good and excellent results and recurrent instability comparable with other long-term follow-up studies of open instability procedures.
authors.affiliation: Naval Medical Center San Diego, Department of Orthopaedic Surgery, 34800 Bob Wilson Dr, Ste 112, San Diego, CA 92134-1112, USA. dtschroder@nmcsd.med.navy.mil
authors.forename: David T
authors.initials: DT
authors.lastname: Schroder
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Provencher
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Mologne
authors.forename: Michael P
authors.initials: MP
authors.lastname: Muldoon
authors.forename: Jay S
authors.initials: JS
authors.lastname: Cox
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D019637:Orthopedic Procedures; D019651:Plastic Surgery Procedures; D012785:Shoulder Joint / Q000601:surgery*; D013334:Students; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States