Hinz Maximilian, Fritsch Lorenz, Siebenlist Sebastian, Lacheta Lucca, Pogorzelski Jonas, Rupp Marco-Christopher, Scheiderer Bastian
Department of Sports Orthopaedics, Technical University of Munich, Munich, Germany.
Knee Surg Sports Traumatol Arthrosc. 2025 Jun;33(6):2237-2243. doi: 10.1002/ksa.12548. Epub 2024 Dec 15.
To evaluate clinical, functional and radiological mid-term outcomes following posterior open-wedge glenoid osteotomy (POWGO) for the treatment of posterior shoulder instability (PSI) associated with increased glenoid retroversion.
Patients who underwent POWGO for the treatment of symptomatic PSI with glenoid retroversion >10° and participated in a previous study assessing short-term outcomes were included after a minimum follow-up of 5 years. Clinical (Rowe score and physical examination) and functional outcomes (Oxford Shoulder Instability Score [OSIS] and visual analogue scale [VAS] for pain) were assessed. Preoperative versus follow-up magnetic resonance imaging (MRI) assessments were compared for changes in posterior humeral head subluxation (PHHS) and progression of osteoarthritis (shoulder osteoarthritis severity [SOAS] score).
Eight patients (nine shoulders) were included 92.0 months (88.0-109.5 months) post-operatively, of which seven patients (eight shoulders) underwent MRI. Shoulder function was good (Rowe score: 80.0 [76.3-91.3], OSIS: 41.0 [31.0-41.5]) and pain levels were low (VAS for pain: 3.0 [1.0-3.0]) at follow-up. Overall, the degree of PHHS did not change between preoperatively and follow-up (p > 0.05). Four shoulders demonstrated PHHS preoperatively, of which two had a centred humeral head at follow-up. Shoulder osteoarthritis progressed significantly (SOAS score: 17.0 [11.0-24.5] to 33.0 [31.0-45.0], p = 0.018). Residual PSI was evident in 75.0% of shoulders.
At mid-term follow-up, POWGO for PSI associated with increased glenoid retroversion led to good functional outcomes but failed to reliably restore posterior shoulder stability and prevent osteoarthritis progression.
Level IV.
评估后路开放楔形肩胛盂截骨术（POWGO）治疗与肩胛盂后倾增加相关的后肩部不稳（PSI）的临床、功能和影像学中期结果。
纳入因症状性PSI且肩胛盂后倾>10°而接受POWGO治疗并参与过一项评估短期结果的先前研究的患者，进行至少5年的随访。评估临床（Rowe评分和体格检查）和功能结果（牛津肩部不稳评分[OSIS]和疼痛视觉模拟量表[VAS]）。比较术前与随访时的磁共振成像（MRI）评估，观察肱骨头后脱位（PHHS）的变化和骨关节炎进展情况（肩部骨关节炎严重程度[SOAS]评分）。
术后92.0个月（88.0 - 109.5个月）纳入8例患者（9个肩部），其中7例患者（8个肩部）接受了MRI检查。随访时肩部功能良好（Rowe评分：80.0[76.3 - 91.3]，OSIS：41.0[31.0 - 41.5]），疼痛程度较低（疼痛VAS：3.0[1.0 - 3.0]）。总体而言，术前与随访时PHHS程度无变化（p>0.05）。4个肩部术前显示有PHHS，其中2个在随访时肱骨头居中。肩部骨关节炎进展显著（SOAS评分：17.0[11.0 - 24.5]至33.0[31.0 - 45.0]，p = 0.018）。75.0%的肩部存在残余PSI。
在中期随访中，POWGO治疗与肩胛盂后倾增加相关的PSI可带来良好的功能结果，但未能可靠地恢复后肩部稳定性并防止骨关节炎进展。
IV级。
