Glenoid Bone Loss – A Retrospective Evaluation of Functional Outcomes after Bone Block Surgery for Anterior Shoulder Instability in High-demand Athletes

Lara, Paulo Henrique Schmidt; Gonçalves, Gabriel Massarico; Zobiole, Alexandre Figueiredo; Silva, Eli Henrique Rodrigues da; Ejnisman, Benno; Belangero, Paulo Santoro

doi:10.1055/S-0043-1768694

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Revista Brasileira de Ortopedia

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Original Article • Rev. bras. ortop. 58 (6) • 2023 • https://doi.org/10.1055/S-0043-1768694 copy

Glenoid Bone Loss – A Retrospective Evaluation of Functional Outcomes after Bone Block Surgery for Anterior Shoulder Instability in High-demand Athletes

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

This study assesses the relationship between the glenoid bone loss size and range of motion, functional outcomes, and complications in high-performance athletes undergoing bone block surgery for anterior shoulder instability.

Methods

This retrospective study evaluated postoperative outcomes in athletes submitted to bone block surgery for anterior shoulder instability. In 5 years, 41 shoulders underwent the procedure; 20 had bone losses up to 15%, and 21 shoulders presented bone losses ranging from 15% and 25%.

Results

There was no statistically significant difference regarding postoperative complications, new dislocations, and the rate of return to sports. In addition, the quantitative criteria evaluated, i.e., ranges of motion and functional scores, showed no statistically significant difference between groups.

Conclusion

The size of the bone loss per se does not seem to affect functional outcomes and complications from these procedures, which are safe techniques for small and large bone losses.

Keywords
athletes; glenoid cavity; grafting, bone; joint instability; shoulder

Sport	Athletes
Soccer	9
Rodeo	9
Handball	4
Jiu Jitsu	4
Muay Thai	2
Other martial arts	2
Rugby	2
Volleyball	2
Boxing	1
Chinese boxing	1
Motocross	1

		≤15%	>15% and ≤25%	Total	p-value
		N = 20	N = 21	Total	p-value
Category	Amateur	14	11	25	0.248
Category	Professional	6	10	16	0.248
Shoulder hyperlaxity	No	16	18	34	0.627
Shoulder hyperlaxity	Yes	4	3	7
Dominant limb	Right	18	21	39	0.137
Dominant limb	Left	2	0	2	0.137
Affected limb	Right	13	11	24	0.412
Affected limb	Left	7	10	17	0.412
Injury mechanism	Atraumatic	5	3	8	0.387
Injury mechanism	Traumatic	15	18	33	0.387
Gender	Female	2	2	4	0.959
Gender	Male	18	19	37	0.959
Performed procedure	Bristow	9	11	20	0.636
Performed procedure	Latarjet	11	10	21	0.636
Glenoid track	Off-track	7	18	25	0.001
Glenoid track	On-track	13	3	16	0.001

		Mean	Standard deviation	P-value
Age	≤15%	24.8	6.6	0.200
Age	>15% and ≤25%	28.0	7.4	0.200
Weight	≤15%	79.1	9.5	0.556
Weight	>15% and ≤25%	76.9	6.9	0.556
Height	≤15%	1.78	0.04	0.530
Height	>15% and ≤25%	1.77	0.06	0.530
Body mass index	≤15%	24.9	2.3	0.584
Body mass index	>15% and ≤25%	24.5	1.5	0.584
Dislocation episodes	≤15%	5.8	5.9	0.004
Dislocation episodes	>15% and ≤25%	9.2	5.7	0.004

	≤15%			>15% and ≤25%		Total		P-value
		N	%	N	%	N	%
Complication	No	16	80%	18	85.7%	34	83%	0.627
Complication	Yes	4	20%	3	14.3%	7	17%	0.627
New dislocations	No	19	95%	20	95.2%	39	95%	0.972
New dislocations	Yes	1	5%	1	4.8%	2	5%	0.972
Return to sports	No	4	20%	4	19.0%	8	20%	0.939
Return to sports	Yes	16	80%	17	81.0%	33	80%	0.939

		≤15%		>15% e ≤25%		P-value
		Mean	SD	Mean	SD	P-value
Passive lateral rotation	Preoperative	74.8	1.2	74.5	1.5	0.336
Passive lateral rotation	5 years	66.3	6.0	66.0	6.0	0.788
Active lateral rotation	Preoperative	71	4.2	71.7	4.6	0.503
Active lateral rotation	5 years	60.5	4.8	60.2	5.6	0.743
Passive elevation	Preoperative	178.0	3.0	176.9	5.1	0.679
Passive elevation	5 years	176.5	2.9	175.7	4.0	0.627
Active elevation	Preoperative	174.1	6.7	173.3	8.9	0.978
Active elevation	5 years	170.3	7.2	167.1	7.0	0.169
VAS	Preoperative	2.7	1.17	1.76	1.04	0.009
VAS	5 years	1.05	0.89	0.71	0.90	0.195
ASES	Preoperative	53.1	5.2	52.4	5.6	0.917
ASES	5 years	80.2	4.0	80.7	4.5	0.674
ASO RS	Preoperative	40.7	20.1	45.4	14.6	0.557
ASO RS	5 years	78.7	8.5	74.2	7.9	0.107
WOSI	Preoperative	153.8	24.7	148.3	24.6	0.522
WOSI	5 years	40.5	7.6	43.2	8.7	0.323

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[1] Address for correspondence Gabriel Massarico Gonçalves, Rua Estado de Israel, 713-Vila Clementino, São Paulo, SP, Brasil, 04022-002 (e-mail: Gabriel_0112@hotmail.com).