Glenoid osteotomy for recurrent posterior subluxation of the shoulder: assessment by computed axial tomography.

Abstract

Computed axial tomography was used to measure the change in articular alignment of 12 patients who underwent glenoid osteotomy for recurrent posterior subluxation of the shoulder. The average correction was 10.8 degrees and varied from -1 degree to +24 degrees. Local complications were intraarticular fracture because of osteotomy too close to the articular surface, lack of correction caused by loss of the anterior cortical hinge, and graft extrusion causing loss of correction. Osteoarthritis was noted in one case after 8 years. Only 2 of the 12 patients had clinical instability after surgery; however, 3 others continued to feel some shoulder discomfort. Despite uniform surgical technique for osteotomy, graft size, and graft placement, more variability was seen in articular realignment than expected. Given this unpredictability and the known risks of articular damage inherent in osteotomy near a joint surface, glenoid osteotomy for recurrent posterior subluxation should be used with caution.