A Modified Technique of Glenoid Osteotomy for Posterior Shoulder Instability

Abstract

Posterior shoulder instability is a rare condition that results from a variety of causes. One such cause is retroversion of the glenoid. We present a novel technique for performing a redirecting osteotomy to a more anatomic version by using instruments initially developed for a high-tibial osteotomy.

Indications and outcomes of glenoid osteotomy for posterior shoulder instability: a systematic review

“…17,18 The mean proportion of males was 80% based on five studies. 15,16,[19][20][21] Mean follow-up was between 1 and 10.8 years based on six studies (9 years [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] 6,10,15,16,20,21 All nine studies used the posterior open wedge technique. Seven studies used an autograft derived from the iliac crest, 10,15,16,[18][19][20][21] two from the acromion, 19,21 two from the scapular spine, 6,18 and one study did not report the autograft source.…”

“…11 The procedure aims to correct the retroversion and achieve centric loading of the glenohumeral joint to re-center the humeral head in its appropriate location. 2,8,10,11 There is limited evidence on the management of posterior shoulder instability. 3 To our knowledge, this is the first systematic review analyzing the indications and outcomes of glenoid osteotomy used to treat this condition.…”

“… 1 Posterior instability accounts for approximately 2–10% of shoulder instability cases and can manifest itself on a spectrum, ranging from mild subluxation to frank dislocation. 2 – 6 Causation is often multifactorial including, glenoid retroversion, trauma, posterior labral tears, hyperlaxity and poor neuromuscular control. 7 – 9 Due to the wide spectrum of clinical manifestations and aetiologies, it can be challenging to determine appropriate indications for treatment.…”

“…These procedures include posterior bone block or, in patients who have excessively retroverted glenoids, glenoid osteotomy (or glenoplasty). 2 Glenoid osteotomy for posterior shoulder instability was first described by Scott in 1967. 11 The procedure aims to correct the retroversion and achieve centric loading of the glenohumeral joint to re-center the humeral head in its appropriate location.…”

“… 11 The procedure aims to correct the retroversion and achieve centric loading of the glenohumeral joint to re-center the humeral head in its appropriate location. 2 , 8 , 10 , 11 …”