Surgeon describes shoulder arthropathy outcomes more than 30 years after Bristow repair for instability

NEW ORLEANS — In a long-term follow-up of 31 shoulders treated with the Bristow-Latarjet repair for instability, Lennart Hovelius, MD, reported that about two-thirds of patients remained satisfied with their surgical result.

Hovelius said his cases were among those from four Swedish hospitals in the original series, which was published in 1983.

“These repairs are the first we did with coracoid standing and one screw. Eleven had previously failed surgery. All patients had the follow-up with X-ray after 33 years. Results: one had revision surgery. None had further surgery of any kind,” he said.

According to Hovelius, a possible strength of this effort was that two observers twice classified nearly the amount of arthropathy in the patients using the Samilson-Prieto system during the 33-years to 35-years follow-up.

However, some of the assessments of arthropathy severity varied between the observers.

“Mean values were 27% mild arthropathy, 23% moderate and 11% severe. We know that more than 50% had arthropathy 20 years after the primary dislocation,” said Hovelius.

He noted that, based on outcomes in this series, perhaps the Western Ontario Shoulder Instability Index is a better system to use to assess patients after Bristow repairs. He said patient outcomes with that index better corresponded with patient’s amount of arthrosis.

“The Samilson classification is perhaps not appropriate,” Hovelius said. – by Susan M. Rapp

Reference:

Hovelius L. Paper #126. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.

Disclosure: Hovelius has no relevant financial disclosures.