Osteolysis

Research on bone research discussed by O. Barbier and co-researchers

"This retrospective study relates to 8 patients, presenting recurrent posterior shoulder instability, all treated with a posterior iliac bone-block procedure. The results were assessed both clinically and with contemporary imaging techniques. - A unique identical surgical technique was used in all these cases including a posterior deltoid head detachment, an infraspinatus muscle dissociation and a bone-block positioning intended to extend and enlarge the glenoid cavity rather than to act as an actual block. Seven of these 8 cases were posttraumatic (including 2 with a concomitant congenital hyperlaxity past history) and the non-traumatic 1 was secondary to an epileptic seizure episode. All the patients had a typical posterior shoulder instability clinical presentation in the form of recurrent true dislocation incidents. In 6 cases, imaging revealed lesions of the humeral head or the glenoid cavity. These lesions were displacement-related anterior impaction defects of the humeral head (McLaughlin lesion) and/or a fracture (or erosion) of the posterior glenoid rim. Mean postoperative follow-up was 34 months. - No cases of postoperative suprascapular nerve deficit were observed. All patients recovered normal joint range of motion in abduction and anterior elevation; in 3 patients, however, external rotation ended up being limited by an average 20. compared to the opposite side. The mean Constant score was 96.25 points and the mean Duplay score 90. Only 4 patients were able to return to their preoperative sports activity level. Three required an additional procedure, 2 for hardware removal and 1 for posterior deltoid repair, which all lead to an uneventful evolution. Imaging at follow-up (X-ray or CT) did not show any instance of bone-block pseudoarthrosis or osteolysis nor did it exhibit glenohumeral early degenerative changes. In all, at a mean 3 years' follow-up, the present series showed satisfactory results in 80% of cases. A literature review found comparable results for bone-block stabilization procedures. No recurrences of instability are reported with this technique, the main difficulty of which residing in the correct positioning of the bone-block. The stabilizing efficacy and low subsequent arthritic changes of the iliac posterior bone-block graft procedure seem thus confirmed by these encouraging results. - The iliac posterior shoulder bone-block is effective in managing instances of involuntary posterior shoulder instability," wrote O. Barbier and colleagues.

The researchers concluded: "A review of the literature confirmed these satisfactory results in terms of non-recurrence, pain relief and function recovery with this technique; th'."

Barbier and colleagues published their study in Orthopaedics & Traumatology - Surgery & Research (Iliac bone-block autograft for posterior shoulder instability. Orthopaedics & Traumatology - Surgery & Research, 2009;95(2):100-107).

For additional information, contact O. Barbier, 21 Rue George Bernard Shaw, F-75015 Paris, France.

Publisher contact information for the journal Orthopaedics & Traumatology - Surgery & Research is: Elsevier Masson, Via Paleocapa 7, 20121 Milano, Italy.

Keywords: France, Paris, Bone Research, Autograft, Bone, Clinical Trials, Dislocations, Epilepsy, Orthopedics, Post-Trials Research, Seizures, Surgery, Traumatology.

This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.