Abstract
Introduction: The incidence of early osteoarthritis after the modified Bristow procedure for recurrent anterior shoulder dislocation has been the subject of several articles during the last decade. Recurrent dislocation, recurrent subluxation after surgery or the procedure itself have been suggested as the main causes of degenerative changes.
Materials and Methods: Thirty-four patients with recurrent anterior dislocation of the shoulder were treated by the same surgeon between May 1989 and April1999. Nineteen patients were allocated for long term follow-up assessment. Patients filled in a questionnaire in which they scored mobility, strength, stability and satisfaction. A Rowe score was established in each patient and radiographs in two directions (AP and axial) were taken.
Results: Twenty shoulders (6 women and 13 men) with an average follow-up of 7.7 years were seen. Seventeen patients had an history of more than 3 dislocations. The mean interval between the first dislocation and surgery was 6.8 years. In all patients a substantial improvement of stability was recorded after surgery. Redislocation occurred in only one patient. The overall satisfaction rate was 6.2. The mean Rowe score at follow-up was 92. There was no limitation in abduction while external rotation was slightly limited in 7 patients. Three patients showed arthritic changes (2 mild, 1 moderate), which, surprisingly, were also seen in the opposite shoulder.
Conclusion: The occurrence of arthropathic changes in a shoulder after surgical stabilisation is based on multiple factors. The recurrent dislocation that has taken place before any surgical procedure plays a predominant role.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
