Purpose of the study
Sports activities requiring antepulsion, adduction and medial rotation can
favor the development of posterior instability of the shoulder. Conservativ
e treatment is indicated, but many techniques have been proposed in case of
failure. All do not allow recovery of the same sports level. We report our
experience with six cases of posterior shoulder instability treated with a
Gosset posterior bone block.
Material and methods
We retrospectively reviewed cases treated between 1974 and 1995. Six athlet
es, aged 17 to 34 years (mean 25 years) underwent posterior bone block surg
ery using the Gosset procedure on their dominant shoulder. Three of the pat
ients had experienced involuntary dislocation and three others involuntary
and voluntary dislocation. One patient had a multidirectional hyperlaxity.
Five patients had participated in rehabilitation programs for at least five
months. Two patients had undergone unsuccessful bone block surgery in anot
her unit.
Results
Stability and pain relief were achieved in all cases. Three patients recove
red complete mobility. In the three others, mean limitation of mobility for
the different sectors was 15 degrees. There has been no sign of osteoarthr
osis at three years follow-up. All patients have resumed their sports activ
ities, three at the same level.
Discussion
In our experience, most surgical techniques proposed for the treatment of p
osterior shoulder instability are unsuccessful. The Gosset iliac bone block
prolongs the articular surface. After consolidation, it allows sports acti
vities requiring shoulder force and provides satisfactory mobility.