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Clinical Orthopaedics and Related Research®

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01-06-2012 | Symposium: Injuries in Overhead Athletes

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Authors: Christophe Lévigne, MD, Jérome Garret, MD, Sophie Grosclaude, MD, Florent Borel, MD, Gilles Walch, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2012

Abstract

Background

Posterosuperior glenoid impingement (PSGI) is the repetitive impaction of the supraspinatus tendon insertion on the posterosuperior glenoid rim in abduction and external rotation. While we presume the pain is mainly caused by mechanical impingement, this explanation is controversial. If nonoperative treatment fails, arthroscopic débridement of tendinous and labral lesions has been proposed but reportedly does not allow a high rate of return to sports. In 1996, we proposed adding abrasion of the bony posterior rim, or glenoidplasty.

Description of Technique

After arthroscopic assessment of internal impingement in abduction-extension-external rotation, extensive posterior labral and partial tendinous tear débridement is performed. Glenoidplasty involves recognition of a posterior glenoid spur and when present subsequent abrasion with a motorized burr.

Methods

We retrospectively reviewed 27 throwing athletes treated between 1996 and 2008. Age averaged 27 years. CT arthrogram showed bony changes on the posterior glenoid rim in 21 shoulders. We evaluated 26 of the 27 patients at a minimum followup of 19 months (mean, 47 months; range, 19–123 months).

Results

Eighteen of the 26 patients resumed their former sport level. Six improved but had to change to an inferior sport level or another sport. Two patients did not improve after the procedure, one of whom changed sport practice. There were no complications or posterior instability. In the 15 patients who had radiographs at followup times from 20 to 87 months, we observed no arthritis or osteophyte.

Conclusions

Comparison with an earlier series of soft tissue débridement shows glenoidplasty improves the likelihood of resuming a former sport level in patients with PSGI.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes
Authors: Christophe Lévigne, MD
Jérome Garret, MD
Sophie Grosclaude, MD
Florent Borel, MD
Gilles Walch, MD
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 6/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2294-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Abstract

Background

Description of Technique

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Description of Technique

Methods

Results

Conclusions

Level of Evidence

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