title: Results of an open posterior bone block procedure for recurrent posterior shoulder instability after a short- and long-time follow-up.
abstract: OBJECTIVE
  The aim of the present study was to analyse and compare the clinical and radiological results after open posterior bone block procedure at long- (LT) and short-term (ST) follow-up. The hypothesis was that placement of a bone block at the posterior glenoid rim in a technique of extending the glenoid surface will create permanent joint stability even in cases with hyperlaxity without a clinically relevant loss of motion or increase in osteoarthritis.
  
  
  METHODS
  Fifteen consecutive shoulders with recurrent posterior dislocation were evaluated clinically and radiologically. The Rowe score, Western Ontario Shoulder Index, Walch-Duplay score and the Constant-Murley score were used for clinical evaluation. The patients were categorized according to their follow-up period as either ST follow-up (min 12 months) or LT follow-up (min 42 months).
  
  
  RESULTS
  The clinical results showed no significant difference between ST (9) and LT (6) with good to very good overall results in the subjective as well as the objective scores (CS, RS, WDS). At LT, most patients felt mild to minor pain under strain. The difference in pain between the groups was not significant. Active ranges of motion and strength assessments were normal in all cases. In one case, recurrent dislocations occurred after bone graft resorption 6 months post-operatively. Only one patient presented mild osteoarthritis, without further progress at follow-up.
  
  
  CONCLUSIONS
  The open posterior bone block procedure can be a successful treatment option for recurrent posterior shoulder instability at ST and LT follow-up. This series showed a low rate of recurrent dislocations without development or progression of osteoarthritis. Since soft tissue procedures do not always provide satisfying results, the posterior bone block augmentation presents a reliable technique for the treatment of symptomatic posterior instability.
  
  
  METHODS
  Case Series, Treatment Study, Level IV.
authors.affiliation: Department Shoulder- and Knee Surgery and Sportsmedicine, Orthopaedic Clinic of the Hanover Medical School in the Annastift Hospital, Anna-von-Borries Str. 1-7, 30625, Hannover, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Struck
authors.affiliation: Department Shoulder- and Knee Surgery and Sportsmedicine, Orthopaedic Clinic of the Hanover Medical School in the Annastift Hospital, Anna-von-Borries Str. 1-7, 30625, Hannover, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wellmann
authors.affiliation: Department Shoulder- and Knee Surgery and Sportsmedicine, Orthopaedic Clinic of the Hanover Medical School in the Annastift Hospital, Anna-von-Borries Str. 1-7, 30625, Hannover, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Becher
authors.affiliation: Department Shoulder- and Knee Surgery and Sportsmedicine, Orthopaedic Clinic of the Hanover Medical School in the Annastift Hospital, Anna-von-Borries Str. 1-7, 30625, Hannover, Germany.
authors.forename: M F
authors.initials: MF
authors.lastname: Pastor
authors.affiliation: Department Shoulder- and Knee Surgery and Sportsmedicine, Orthopaedic Clinic of the Hanover Medical School in the Annastift Hospital, Anna-von-Borries Str. 1-7, 30625, Hannover, Germany. Tomas.Smith@ddh-gruppe.de.
authors.forename: T
authors.initials: T
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D012540:Scapula / Q000601:surgery; D012783:Shoulder Dislocation / Q000175:diagnosis / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D055815:Young Adult
keywords: Hyperlaxity; Osteoarthritis; Posterior bone block; Posterior shoulder instability