Posterior glenoid bone block transfer for posterior shoulder instability: a systematic review

Abstract

Background: The purpose of this study is to systematically review the literature and evaluate patient-reported outcomes and complication/revision rates of bone block augmentation in the treatment of posterior shoulder instability (PSI).

Methods: PubMed was searched according to PRIMSA guidelines to find clinical studies evaluating patient-reported outcomes, revision, and complication rates in posterior bone block for PSI. A literature search of MEDLINE, EMBASE, and the Cochrane Library was performed based on the PRISMA guidelines. Clinical studies reporting on the complications following posterior bone block were included.

Results: Overall, 11 studies (level of evidence [LOE] III: 2, LOE IV: 9) met inclusion criteria, with 225 shoulders. Recurrent instability after the posterior bone block was found to be 9.8%. The overall complication rate was 13.8%, with 0.89% having graft complications, 11.1% having hardware complications, 0.4% having wound complications, 0.4% having nerve complications, and 0.89% having other complications. Residual pain was found in 11.6% of shoulders operated on. Patient-reported outcomes were evaluated most commonly by Rowe (81.4%), Constant (84.6%), and Walch-Duplay scores (81.6%).

Conclusion: There is a moderate rate of recurrence following posterior bone block for PSI. However, the patient-reported outcomes are high despite there being commonly reported persistent shoulder pain postoperatively.

Keywords: Posterior bone block; allograft; augmentation; autograft; glenoid bone loss; shoulder instability.