Corrective Posterior Opening-wedge Glenoid Neck Osteotomy for Excessive Retroversion

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Abstract

Excessive retroversion of the glenoid can cause eccentric loading of the glenohumeral joint and may lead to posterior shoulder instability, posterior labral tears, functional impairment, static posterior shoulder subluxation, and progressive glenohumeral arthropathy. For young patients surgical options are limited and include open labral repair and capsular plication, arthroscopic labral repair and capsular plication, or open posterior opening-wedge glenoid osteotomy. Of these, only the osteotomy can correct the glenoid retroversion and recenter the humeral head. Here, we detail our preoperative work-up, the surgical technique and the postoperative protocol for a corrective posterior opening-wedge corrective glenoid osteotomy. Multiple studies have showed that children, adolescents, and young adults with severe glenoid retroversion may benefit from this treatment. This surgery is technically challenging and should have narrow surgical indications. Patients can demonstrate improved radiographic bony architecture of the glenohumeral joint, diminished pain, and improved function.

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