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The Modified Bristow Procedure for Anterior Shoulder Instability: 26-Year Outcomes in Naval Academy Midshipmen

Background Many procedures have been proposed for the correction of anterior shoulder instability. Some of these procedures address the problem anatomically, such as the Bankart procedure, and some prevent instability nonanatomically, such as the Bristow-Latarjet procedure. A modified Bristow proced...

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Published in:The American journal of sports medicine 2006-05, Vol.34 (5), p.778-786
Main Authors: Schroder, David T., Provencher, Matthew T., Mologne, Timothy S., Muldoon, Michael P., Cox, Jay S.
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Provencher, Matthew T.
Mologne, Timothy S.
Muldoon, Michael P.
Cox, Jay S.
description Background Many procedures have been proposed for the correction of anterior shoulder instability. Some of these procedures address the problem anatomically, such as the Bankart procedure, and some prevent instability nonanatomically, such as the Bristow-Latarjet procedure. A modified Bristow procedure was the procedure of choice for anterior shoulder instability among midshipmen at the United States Naval Academy from 1975 to 1979. Hypothesis The modified Bristow procedure for anterior shoulder instability provides good shoulder function and stability in the long term. Study Design Case series; Level of evidence, 4. Methods There were 52 shoulders in 49 patients reviewed at a mean follow-up of 26.4 years. The Rowe score, Single Assessment Numeric Evaluation, and Western Ontario Shoulder Instability Index were used to assess outcomes. Results The mean Rowe score was 81.8 (range, 5-100), and the mean Single Assessment Numeric Evaluation score was 82.9 (range, 30-100), with an overall Single Assessment Numeric Evaluation of 71.2% (37 of 52 shoulders) rated as good and excellent. The mean Western Ontario Shoulder Instability Index was 376 of 2100 (range, 0-1560). Overall, recurrent instability occurred in 8 of 52 shoulders (15.4%), with recurrent dislocation in 5 shoulders (9.6%) and recurrent subluxation in 3 shoulders (5.8%). The mean time to recurrent dislocation was 7.0 years. Conclusion This study represents the longest follow-up in the literature of the modified Bristow procedure. The authors have shown nearly 70% good and excellent results and recurrent instability comparable with other long-term follow-up studies of open instability procedures.
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Some of these procedures address the problem anatomically, such as the Bankart procedure, and some prevent instability nonanatomically, such as the Bristow-Latarjet procedure. A modified Bristow procedure was the procedure of choice for anterior shoulder instability among midshipmen at the United States Naval Academy from 1975 to 1979. Hypothesis The modified Bristow procedure for anterior shoulder instability provides good shoulder function and stability in the long term. Study Design Case series; Level of evidence, 4. Methods There were 52 shoulders in 49 patients reviewed at a mean follow-up of 26.4 years. The Rowe score, Single Assessment Numeric Evaluation, and Western Ontario Shoulder Instability Index were used to assess outcomes. Results The mean Rowe score was 81.8 (range, 5-100), and the mean Single Assessment Numeric Evaluation score was 82.9 (range, 30-100), with an overall Single Assessment Numeric Evaluation of 71.2% (37 of 52 shoulders) rated as good and excellent. The mean Western Ontario Shoulder Instability Index was 376 of 2100 (range, 0-1560). Overall, recurrent instability occurred in 8 of 52 shoulders (15.4%), with recurrent dislocation in 5 shoulders (9.6%) and recurrent subluxation in 3 shoulders (5.8%). The mean time to recurrent dislocation was 7.0 years. Conclusion This study represents the longest follow-up in the literature of the modified Bristow procedure. 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Some of these procedures address the problem anatomically, such as the Bankart procedure, and some prevent instability nonanatomically, such as the Bristow-Latarjet procedure. A modified Bristow procedure was the procedure of choice for anterior shoulder instability among midshipmen at the United States Naval Academy from 1975 to 1979. Hypothesis The modified Bristow procedure for anterior shoulder instability provides good shoulder function and stability in the long term. Study Design Case series; Level of evidence, 4. Methods There were 52 shoulders in 49 patients reviewed at a mean follow-up of 26.4 years. The Rowe score, Single Assessment Numeric Evaluation, and Western Ontario Shoulder Instability Index were used to assess outcomes. Results The mean Rowe score was 81.8 (range, 5-100), and the mean Single Assessment Numeric Evaluation score was 82.9 (range, 30-100), with an overall Single Assessment Numeric Evaluation of 71.2% (37 of 52 shoulders) rated as good and excellent. The mean Western Ontario Shoulder Instability Index was 376 of 2100 (range, 0-1560). Overall, recurrent instability occurred in 8 of 52 shoulders (15.4%), with recurrent dislocation in 5 shoulders (9.6%) and recurrent subluxation in 3 shoulders (5.8%). The mean time to recurrent dislocation was 7.0 years. Conclusion This study represents the longest follow-up in the literature of the modified Bristow procedure. 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schroder, David T.</au><au>Provencher, Matthew T.</au><au>Mologne, Timothy S.</au><au>Muldoon, Michael P.</au><au>Cox, Jay S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Modified Bristow Procedure for Anterior Shoulder Instability: 26-Year Outcomes in Naval Academy Midshipmen</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2006-05-01</date><risdate>2006</risdate><volume>34</volume><issue>5</issue><spage>778</spage><epage>786</epage><pages>778-786</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background Many procedures have been proposed for the correction of anterior shoulder instability. Some of these procedures address the problem anatomically, such as the Bankart procedure, and some prevent instability nonanatomically, such as the Bristow-Latarjet procedure. A modified Bristow procedure was the procedure of choice for anterior shoulder instability among midshipmen at the United States Naval Academy from 1975 to 1979. Hypothesis The modified Bristow procedure for anterior shoulder instability provides good shoulder function and stability in the long term. Study Design Case series; Level of evidence, 4. Methods There were 52 shoulders in 49 patients reviewed at a mean follow-up of 26.4 years. The Rowe score, Single Assessment Numeric Evaluation, and Western Ontario Shoulder Instability Index were used to assess outcomes. Results The mean Rowe score was 81.8 (range, 5-100), and the mean Single Assessment Numeric Evaluation score was 82.9 (range, 30-100), with an overall Single Assessment Numeric Evaluation of 71.2% (37 of 52 shoulders) rated as good and excellent. The mean Western Ontario Shoulder Instability Index was 376 of 2100 (range, 0-1560). Overall, recurrent instability occurred in 8 of 52 shoulders (15.4%), with recurrent dislocation in 5 shoulders (9.6%) and recurrent subluxation in 3 shoulders (5.8%). The mean time to recurrent dislocation was 7.0 years. Conclusion This study represents the longest follow-up in the literature of the modified Bristow procedure. The authors have shown nearly 70% good and excellent results and recurrent instability comparable with other long-term follow-up studies of open instability procedures.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>16399933</pmid><doi>10.1177/0363546505282618</doi><tpages>9</tpages></addata></record>
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subjects Adolescent
Adult
Athletic Injuries - surgery
Biological and medical sciences
Clinical outcomes
Diseases of the osteoarticular system
Female
Humans
Injuries
Joint Instability - surgery
Joint surgery
Male
Medical sciences
Military Medicine
Military Personnel
Orthopedic Procedures
Physiological aspects
Reconstructive Surgical Procedures
Shoulder
Shoulder Joint - surgery
Sports medicine
Students
Surveys and Questionnaires
Suture Techniques
Time Factors
Treatment Outcome
United States
title The Modified Bristow Procedure for Anterior Shoulder Instability: 26-Year Outcomes in Naval Academy Midshipmen
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