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The Journal of Bone and Joint Surgery 83:593 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Shoulder Arthrodesis

David J. Clare, MD, Michael A. Wirth, MD, Gordon I. Groh, MD and Charles A. Rockwood, Jr., MD

Investigation performed at the Department of Orthopaedics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
David J. Clare, MD Nebraska Orthopaedic and Sports Medicine, 6940 Van Dorn, Suite 201, Lincoln, NE 68506. E-mail address: clare{at}cornhusker.net
Michael A. Wirth, MD Charles A. Rockwood Jr., MD Department of Orthopaedics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7774, San Antonio, TX 78229-3900. E-mail address for M.A.Wirth: wirth@uthscsa.edu. E-mail address for C.A. Rockwood Jr.: rockwood@uthscsa.edu
Gordon I. Groh, MD Blue Ridge Bone and Joint Clinic, 129 McDowell Street, Asheville, NC 28801-4434. E-mail address: ggroh210@aol.com
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Current indications for shoulder arthrodesis include posttraumatic brachial plexus injuries, paralysis of the deltoid muscle and rotator cuff, chronic infection, failed revision arthroplasty, severe refractory instability, and bone deficiency following resection of a tumor in the proximal aspect of the humerus.

The trapezius, levator scapulae, serratus anterior, and rhomboid muscles must be functional to optimize the functional result following shoulder arthrodesis.

A consensus has not been reached concerning the ideal position of the shoulder arthrodesis, although excessive abduction or flexion has been associated with chronic postoperative pain.

Decortication of both the acromiohumeral and the glenohumeral surfaces to increase the surface area available for arthrodesis is the most common means for obtaining successful fusion.

Although there are numerous methods for stabilization of a shoulder arthrodesis, the most popular method today is probably the AO technique with either a single plate or double plates.


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