Posterior Shoulder Instability With Bone Loss – What surgical options are available?

Who is Dr. Brent J. Morris?

Dr. Brent J. Morris is an orthopedic shoulder and elbow surgeon in Lexington, Kentucky at Baptist Health Lexington – Orthopedics and Sports Medicine. Dr. Morris is a fellowship-trained shoulder and elbow specialist with additional interest in primary and revision total shoulder replacement surgery.  Dr. Morris is co-author of a textbook devoted to total shoulder, reverse total shoulder, and revision shoulder replacement surgery, Shoulder Arthroplasty, 2ndEdition.

Posterior shoulder instability is not nearly as common as anterior shoulder instability, but it is still relatively common in the office of a shoulder specialist. Patients with posterior shoulder instability often present to our shoulder clinic because they have significant posterior shoulder pain often following a traumatic event.  Non-surgical options are initiated to improve symptoms; however, some patients with severe posterior shoulder instability, especially with bone loss, often do progress to the point of needing shoulder surgery to correct their problem.

Posterior shoulder instability is not nearly as common as anterior shoulder instability, but it is still relatively common in the office of a shoulder specialist. Patients with posterior shoulder instability often present to our shoulder clinic because they have significant posterior shoulder pain often following a traumatic event.  Non-surgical options are initiated to improve symptoms; however, some patients with severe posterior shoulder instability, especially with bone loss, often do progress to the point of needing shoulder surgery to correct their problem.

Posterior shoulder dislocation is often associated with bone defects. Surgical treatment is often necessary to address these lesions. Dr. Morris is a shoulder specialist with experience treating posterior shoulder instability.  Dr. Morris and his colleagues also completed a recent journal article that analyzed the available literature concerning bone block procedures in the treatment of bone deficiencies following posterior dislocation.

Dr. Morris and his colleagues wanted to know how patients do following posterior bone block procedures for posterior instability, so they studied this and published the results.  https://sa1s3.patientpop.com/assets/docs/26073.pdf

  1. Bone grafting is a reliable treatment for posterior shoulder instability with bone loss.

 

  1. Bone grafting for posterior shoulder instability appears to be associated with a low incidence of recurrent instability.

 

  1. Post-traumatic shoulder joint arthritis and osteolysis of the bone graft can develop over time.
Takeaway:

The overall takeaway from the study was that there can be significant improvements after bone grafting for posterior shoulder instability with bone loss, but longer-term follow-up is needed.  Post-traumatic arthritis can occur (as occurs with anterior shoulder instability) and bone graft osteolysis as a result of Wolff’s law does develop.

Citation:

Cerciello S, Visonà E, Morris BJ, Corona K. Bone block procedures in posterior shoulder instability. Knee Surgery, Sports Traumatology, Arthroscopy. 04/2015. DOI:10.1007/s00167-015-3607-7

About Dr. Morris:

Dr. Brent J. Morris is a board-certified orthopedic surgeon and fellowship-trained shoulder and elbow specialist in Lexington, Kentucky at Baptist Health Lexington – Orthopedics and Sports Medicine.  Dr. Morris is a fellow of the American Academy of Orthopedic Surgeons (FAAOS) and an Active Member of American Shoulder and Elbow Surgeons (ASES).

Dr. Morris and his research team have published extensively on shoulder surgery and ways to improve outcomes and patient satisfaction following surgery.  He is co-author of a textbook devoted to total shoulder, reverse total shoulder replacement surgery, and revision shoulder replacement surgery, Shoulder Arthroplasty, 2ndEdition (https://www.elsevier.com/books/shoulder-arthroplasty/edwards/978-0-323-53164-1). 

For more information about Dr. Morris, visit online at www.brentmorrismd.com.

Brent J. Morris, MD

Author

Dr. Brent J. Morris