title: Does Weber's rotation osteotomy induce degenerative joint disease at the shoulder in the long term?
abstract: Weber's internal rotation osteotomy of the humeral head is recommended for the treatment of anteroinferior shoulder instability with a large Hill-Sachs defect. The observation of severe joint degeneration in the course of long-term follow-up provided the motivation for this study. An osteotomy was performed in 42 patients from 1984 to 1990. Thirty-four patients were available for clinical and radiological follow-up after 14.5 years. Our own CT-based classification was applied to categorize the degree of osteoarthritis. A shoulder prosthesis was implanted in 9 patients (26%). Only 3 patients (9%) did not show any signs of degeneration. A statistically significant relationship was found between increased internal rotation of the humeral head and disease severity (P = .03). A lower incidence of joint degeneration (P = .02) was found for patients with generalized ligamentous laxity. We therefore recommend this osteotomy only as a salvage procedure whereby the internal rotation of the humeral head should not exceed 20 degrees .
authors.affiliation: Schulthess Klinik, Department of Orthopedics, Upper Extremity Unit, Lengghalde, Switzerland. matthias.flury@kws.ch
authors.forename: Matthias P
authors.initials: MP
authors.lastname: Flury
authors.forename: Joerg
authors.initials: J
authors.lastname: Goldhahn
authors.forename: Patrick
authors.initials: P
authors.lastname: Holzmann
authors.forename: Beat R
authors.initials: BR
authors.lastname: Simmen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000473:pathology; D007592:Joint Diseases / Q000209:etiology*; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects*; D019919:Prosthesis Implantation; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000473:pathology* / Q000601:surgery*