Postoperative ossifications of the shoulder - Incidence and clinical impact

Periarticular ossifications of the shoulder after surgery have been describ ed since the beginning of the century. Risk factors and the clinical impact of heterotopic bone formation have been discussed controversially. After o pen surgery on the shoulder, 131 patients (rotator cuff repair n = 106, acr omioplasty n = 25) were included in a retrospective study if pre- and posto perative X-rays were available. The age of the 90 men and 41 women averaged 51 years (range 29-67 years). The minimum follow-up was 2 years. Also, 108 patients were interviewed by questionnaire to estimate the subjective outc ome of the procedure (5 patients were reported dead). A clinical examinatio n was carried out on 86 patients using the Constant score for evaluation of the objective outcome. Heterotopic ossifications were found in 35 cases (2 6.7%), 28 of them after rotator cuff reconstruction and 7 after acromioplas ty. A good to excellent result was reported by 89% (n = 65) of the patients without and by 80% (n = 28) of the patients with ossifications. The Consta nt score averaged 69 points and 74 points (n = 60), respectively. A signifi cant difference between the two collectives could not be calculated. As sig nificant risk factors for the formation of heterotopic bane, the existence of osteoarthritis and the duration and complexity of the procedure could be cited. The appearance of periarticular ossifications after surgery of the shoulder seems to be of minor clinical impact. Severe cases with major func tional deficits should and can be prevented by a fast and atraumatic operat ion technique.