Bone Block Augmentation of the Posterior Glenoid for Recurrent Posterior Shoulder Instability Is Associated With High Rates of Clinical Failure: A Systematic Review

Arthroscopic Bone Block Procedure for Posterior Shoulder Instability: Updated Surgical Technique

“… 17 , 18 However, bone block procedures are still associated with high complication rates. 5 Symptomatic hardware problems are the most common complications, especially insertion of screws remains challenging. 5 , 6 , 9 , 19 Posterior open-wedge glenoid osteotomy, used in patients with excessive glenoid retroversion, is associated with high reported rates of recurrent PSI (86%) and osteoarthritis (100%) at long-term follow-up.…”

“… 5 Symptomatic hardware problems are the most common complications, especially insertion of screws remains challenging. 5 , 6 , 9 , 19 Posterior open-wedge glenoid osteotomy, used in patients with excessive glenoid retroversion, is associated with high reported rates of recurrent PSI (86%) and osteoarthritis (100%) at long-term follow-up. 12 Bone block procedures using distal tibial grafts have shown good clinical outcomes, but literature on this procedure is scares.…”

“…Several surgical techniques to treat PSI have been described, including soft-tissue repair and both open and arthroscopic bone block procedures. 5 In 2012, Lafosse et al proposed an arthroscopic posterior bone block technique using an iliac crest bone graft for both bony and soft-tissue defects, with good clinical results. 6,7 However, even though patient-reported outcomes are commonly high, posterior bone block procedures are associated with high complication and revision rates of up to 14% and 67%, respectively.…”

“…Several surgical techniques to treat PSI have been described, including soft-tissue repair and both open and arthroscopic bone block procedures. 5 In 2012, Lafosse et al . proposed an arthroscopic posterior bone block technique using an iliac crest bone graft for both bony and soft-tissue defects, with good clinical results.…”

“… 6 , 7 However, even though patient-reported outcomes are commonly high, posterior bone block procedures are associated with high complication and revision rates of up to 14% and 67%, respectively. 5 , 8 In particular, accurate placement of the bone graft, screw orientation, and the treatment of concomitant lesions are considered challenging. 9 Therefore, improvement of surgical techniques is desirable.…”