Effectiveness of glenoid osteotomy in atraumatic posterior instability of the shoulder associated with excessive retroversion and flatness of the glenoid.

Abstract

In this investigation, patients with atraumatic posterior instability of the shoulder were appraised in order to evaluate the effectiveness of glenoid osteotomy in the correction of excessive retroversion and flatness of the glenoid. In a series of 32 patients, 17 with posterior instability had no history of trauma. Posterior glenoid osteotomy was performed to correct excessive retroversion and to deepen the glenoid; 95% were re-examined after 5 years. In 81% the results were rated as good or excellent (Constant-Murley and Rowe scores), only 12.5% having had a recurrence. The glenoid could be deepened and on average the angle could be altered from -9.35 degrees to -4.62 degrees. In comparison, 50 volunteers had average angles of -4.4 degrees, thus differing significantly from the preoperative group. Twenty-five per cent of the patients showed postoperative degenerative changes in the glenohumeral joint. The study shows that excessive retroversion and flatness of the glenoid in persons with atraumatic posterior instability can be successfully treated by a posterior glenoid osteotomy. Nevertheless, the high rate of postoperative degenerative changes must be taken into account.