Open Shoulder Stabilization Procedure Using Bone Block Technique for Treatment of Chronic Glenohumeral Instability Associated With Bony Glenoid Deficiency
Michael Khazzam, MD, Steven M. Kane, MD, and Matthew J. Smith, MD
Dr. Khazzam is Resident Physician, Department of Orthopaedic Surgery, University of Missouri–Columbia and University of Missouri Hospitals and Clinics, Columbia, Missouri.
Dr. Kane is Chairman and Program Director, Atlanta Medical Center Orthopedic Surgery Residency, Atlanta, Georgia.
Dr. Smith is Assistant Professor, Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.
We examined the early results of using an open bone block technique to stabilize the glenohumeral joint with chronic instability related to bony deficiency of the glenoid. Fifteen patients with anteroinferior glenoid bone loss on preoperative computed tomography underwent diagnostic shoulder arthroscopy (for evaluation of glenoid bony deficiency) and then open bone block augmentation of the anteroinferior glenoid rim.
Clinical follow-up of 10 patients at a mean of 25 months showed a mean postoperative Constant score of 94 (range, 32-100), a mean University of California Los Angeles score of 32 (range, 9-35), and a mean American Shoulder and Elbow Surgeons score of 83 (range, 47-100). Mean postoperative forward flexion was 172°, mean postoperative external rotation with the arm at the side was 60°, mean postoperative external rotation with the arm abducted 90° was 91°, and postoperative internal rotation ranged from the level of the anterosuperior iliac spine (minimal external rotation) to the T6 spinal level.
Bone block stabilization is an effective treatment in patients with chronic shoulder instability—a difficult population.