Posterior Glenohumeral Instability: Diagnosis and Management.

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Abstract

[Indexed for MEDLINE] 20. J Shoulder Elbow Surg. 2021 Dec;30(12):2904-2909. doi: 10.1016/j.jse.2021.06.013. Epub 2021 Jul 21. Posterior glenoid bone block transfer for posterior shoulder instability: a systematic review. Mojica ES(1), Schwartz LB(2), Hurley ET(2), Gonzalez-Lomas G(2), Campbell KA(2), Jazrawi LM(2). Author information: (1)Division of Sports Medicine, Department of Orthopaedic Surgery, NYU Langone Health, New York, NY, USA. Electronic address: edward.mojica@nyulangone.org. (2)Division of Sports Medicine, Department of Orthopaedic Surgery, NYU Langone Health, New York, NY, USA. BACKGROUND: The purpose of this study is to systematically review the literature and evaluate patient-reported outcomes and complication/revision rates of bone block augmentation in the treatment of posterior shoulder instability (PSI). METHODS: PubMed was searched according to PRIMSA guidelines to find clinical studies evaluating patient-reported outcomes, revision, and complication rates in posterior bone block for PSI. A literature search of MEDLINE, EMBASE, and the Cochrane Library was performed based on the PRISMA guidelines. Clinical studies reporting on the complications following posterior bone block were included. RESULTS: Overall, 11 studies (level of evidence [LOE] III: 2, LOE IV: 9) met inclusion criteria, with 225 shoulders. Recurrent instability after the posterior bone block was found to be 9.8%. The overall complication rate was 13.8%, with 0.89% having graft complications, 11.1% having hardware complications, 0.4% having wound complications, 0.4% having nerve complications, and 0.89% having other complications. Residual pain was found in 11.6% of shoulders operated on. Patient-reported outcomes were evaluated most commonly by Rowe (81.4%), Constant (84.6%), and Walch-Duplay scores (81.6%). CONCLUSION: There is a moderate rate of recurrence following posterior bone block for PSI. However, the patient-reported outcomes are high despite there being commonly reported persistent shoulder pain postoperatively. Copyright © 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jse.2021.06.013