Clinical outcomes and care in patients with posterior glenohumeral instability treated with bone block technique.

Abstract

Introduction: Arthroscopic bone block surgery for the treatment of recurrent posterior glenohumeral instability (PGHI) is currently a valid option in the hands of an experienced surgeon. The aim of this retrospective study is to evaluate the clinical and radiological results of this procedure at a minimum 2-year follow-up, emphasizing the importance of a proper rehabilitation protocol.

Materials and methods: Eleven patients with a history of recurrent posterior shoulder instability underwent arthroscopic bone block surgery from autologous iliac crest graft, from 2019 to 2024. All the patients were selected considering Moroder's ABC classification, the level of pain (Numeric Pain Rating Scale, NPRS), functional abilities assessed via the Constant-Murley Score (CMS), the Rowe score, imaging, at baseline and least 2 years after surgery.

Results: The Constant-Murley Score improved from 66 to 87 points, the Rowe score improved from 16 to 77 points, the level of pain (NPRS) decreased after treatment. The bone block was found to be intact in 8 patients, while the presence of a focus of resorption was observed in 3 patients, especially around the screws.

Conclusions: This single-center, retrospective study of 11 patients shows how the surgical bone block procedure for recurrent forms of glenohumeral instability produces good clinical and functional outcomes when performed in the presence of an expert surgeon and with a specific post-operative rehabilitation program.