Short-Term Outcomes of Glenoid Bone Block Augmentation for Complex Anterior Shoulder Instability in a High-Risk Population.
Purpose: To describe the short-term clinical outcomes of glenoid bone block augmentation in a high-demand population, as well as to describe its clinical success and complications at greater than 2 years' follow-up in an at-risk military population.Methods: All patients undergoing anterior capsulorr...
| Publicado en: | Arthroscopy: The Journal of Arthroscopy & Related Surgery Vol. 32; no. 9; pp. 1784 - 1791 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=117707413&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 117707413 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07498063 10OH jtl: Arthroscopy: The Journal of Arthroscopy & Related Surgery issn: 07498063 maglogo: N pubinfo: dt: Sep2016 vid: 32 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 117707413 117707413 NLM27132776 117707413 10.1016/j.arthro.2016.01.051 NLM27132776 117707413 ppf: 1784 ppct: 7 formats: tig: atl: Short-Term Outcomes of Glenoid Bone Block Augmentation for Complex Anterior Shoulder Instability in a High-Risk Population. aug: au: Waterman, Brian R. Chandler, Philip J. Teague, Edward Provencher, Matthew T. Tokish, John M. Pallis, Mark P. affil: Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, El Paso, Texas, U.S.A. sug: subj: Shoulder Joint Surgery Joint Instability Surgery Military Personnel Autografts Middle Age Ilium Transplantation Recurrence Allografts Prospective Studies Young Adult Female Postoperative Complications Retrospective Design Tibia Transplantation Shoulder Pain Etiology Male United States Adult Scales Short Portable Mental Status Questionnaire Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: Purpose: To describe the short-term clinical outcomes of glenoid bone block augmentation in a high-demand population, as well as to describe its clinical success and complications at greater than 2 years' follow-up in an at-risk military population.Methods: All patients undergoing anterior capsulorrhaphy with coracoid process transfer or anterior bone block augmentation (Current Procedural Terminology code 23662 or 23460) for shoulder instability between 2006 and 2012 were isolated from the Military Health System Management Analysis and Reporting Tool. Demographic and occupational parameters were identified, and multiple surgical factors and clinical outcomes were extracted from the medical record and US Defense Manpower Data Center.Results: A total of 64 service members (65 shoulders) underwent anterior bone block procedures, including coracoid transfer (n = 59, 90.8%), distal tibial allograft (n = 3, 4.6%), and autologous or allograft iliac crest bone graft (n = 3, 4.6%). This group was predominately comprised of men (n = 59), and the mean age was 25.9 years (range, 19 to 45 years). A total of 19 perioperative complications, including 8 neurologic injuries, 6 infections, and 4 hardware failures, occurred in 16 patients (25%). At a mean 2.4-year follow-up, 21 patients (32.8%) reported persistent shoulder pain and 15 patients (23.4%) disclosed subjective apprehension or recurrent instability. Secondary surgical procedures were performed in 12 patients (18.8%), including 4 revisions (6.3%). Ultimately, 20 patients (31.3%) underwent a medical discharge for persistent shoulder disability. Univariate analysis showed that the presence of a perioperative complication (P = .049) and tobacco use (P = .038) were associated with increased risk of subsequent surgical failure.Conclusions: Anterior glenoid bone block procedures for shoulder instability with concomitant bone loss enable a return to high-demand physical function. The short-term complication profile (25%), recurrence rate (23%), and persistence of shoulder pain (33%) should be emphasized during preoperative counseling, particularly in an active military population and revision setting. Although moderately successful in the military, anterior bone block procedures for complex shoulder instability can be associated with significant short-term complications and morbidity.Level Of Evidence: Level IV, therapeutic case series. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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