Does Weber's rotation osteotomy induce degenerative joint disease at the shoulder in the long term?

Abstract

Weber's internal rotation osteotomy of the humeral head is recommended for the treatment of anteroinferior shoulder instability with a large Hill-Sachs defect. The observation of severe joint degeneration in the course of long-term follow-up provided the motivation for this study. An osteotomy was performed in 42 patients from 1984 to 1990. Thirty-four patients were available for clinical and radiological follow-up after 14.5 years. Our own CT-based classification was applied to categorize the degree of osteoarthritis. A shoulder prosthesis was implanted in 9 patients (26%). Only 3 patients (9%) did not show any signs of degeneration. A statistically significant relationship was found between increased internal rotation of the humeral head and disease severity (P = .03). A lower incidence of joint degeneration (P = .02) was found for patients with generalized ligamentous laxity. We therefore recommend this osteotomy only as a salvage procedure whereby the internal rotation of the humeral head should not exceed 20 degrees .