Recurrent posterior shoulder instability—Long‐term results after arthroscopic posterior bone block with capsular reconstruction
Bibliographic record
Abstract
Abstract Purpose This study reports the long‐term post‐operative clinical outcomes after arthroscopic posterior bone block augmentation with posterior capsular repair. Methods Eighteen shoulders (13 patients) with unidirectional posterior shoulder instability were treated with an arthroscopic posterior bone block augmentation and posterior capsular repair in 2011 and 2013 in a single specialized orthopaedic clinic. These patients were invited to participate in a clinical and radiological follow‐up examination to receive long‐term results regarding clinical outcomes, instability, and development of osteoarthritis (OA). Results From the initial study group, 13 patients (18 shoulders) could be obtained for a follow‐up examination. The mean follow‐up period was 111 months. At the final follow‐up, two patients (two shoulders) reported recurrent subluxations with a positive apprehension sign. No redislocation was reported. Screw fixation was still in place in seven patients (38.9%). Overall, good clinical outcomes were achieved among Constant–Murley score (77.6 ± 16; p = 0.55), Rowe score (67.5 ± 22.1; p = 0.34), Walch–Duplay score (58.3 ± 28.2) and Western Ontario Shoulder Index (40.4 ± 23.3%; p = 0.96), showing insignificant changes compared with the 2‐year results. Three shoulders developed severe OA (Samilson and Prieto III). No patient required arthroplasty. Conclusion Arthroscopic posterior bone block augmentation with posterior capsular repair represents a salvage procedure that can achieve long‐term shoulder stability with overall moderate clinical results. Patients have to be informed about the probable need for implant removal and the high risk of OA development, especially in the presence of pre‐existing cartilage damage, beforehand. Level of Evidence Level IV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".