The Allman Modification of the Bristow Procedure for Recurrent Anterior Glenohumeral Instability

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Abstract
The Bristow procedure has undergone several modifications since Latarjet's original description in 1954. Throughout all the variations, the main principle remains in that the transferred bone block and muscle unit act as a mechanical buttress and sling to reinforce the weak anterior glenohumeral capsule. Several authors have reported satisfactory follow-up results with low rates of dislocation. However, multiple reports exist of complications involving hardware migration and damage to neurovascular structures. We review our previously reported follow-up on 79 shoulders after an Allman modification of the Bristow procedure at an average postoperative time of 8.6 years. The redislocation rate was 4% with average loss of external rotation of 9° and internal rotation 5°. Fourteen percent of shoulders required reoperation, the majority for screw removal. The likelihood of a quick return to full participation in athletics is good, except for the throwing athlete. The modified Bristow procedure provides excellent long-term stability with minimal loss of external rotation. Intraoperative radiographs are recommended to assure proper bone block placement. Patient satisfaction remains high regarding functional outcome.

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