Question:Thirty years ago I had a special operation called the Bristow for a shoulder dislocation. It seems to have held up pretty good but now I'm getting some arthritis. Is that from the surgery or the dislocation?
Cases of joint arthritis after a traumatic injury are very common. This is true for any joint, not just the shoulder. The type of operation you had is also linked with a higher rate of arthritis afterwards.
The Bristow procedure named after W. Rowley Bristow, MD was used most often back in the 1970s when shoulder repairs were done with an open incision. Today, arthroscopic surgery has replaced open procedures in many cases.
The Bristow procedure transferred the tip of the coracoid process to the front of the shoulder socket. The coracoid process is part of the scapula (shoulder blade) that juts forward toward the front of the shoulder.
The idea was to use this piece of bone to reinforce the shoulder socket. It kept the head of the humerus (upper arm) from popping out of the socket. Usually a piece of muscle was also attached like a sling to help as well.
The Bristow procedure is still used in Europe but has been replaced by other methods now in the U.S. There were concerns about restricted motion and arthritis leading to the development of other methods of surgical repair. The coracoid transfer is still used for some patients. Long-term results have been excellent bringing this method back to the attention of orthopedic surgeons for a second look.LCDR David T. Schroder, MD, MC USNR, et al. The Modified Bristow Procedure for Anterior Shoulder Instability. In The American Journal of Sports Medicine. May 2006. Vol. 34. No. 5. Pp. 778-786.
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