The role of glenoid dysplasia in the pathogenesis of recurrent shoulder instability

Cover Page

Abstract

The purpose - to analyze computerized tomography data in patients with recurrent shoulder instability for signs of glenoid dysplasia. Methods. We studied the diagnostic data and the results of surgical treatment of 168 patients (137 men and 31 women) mostly of young age (under 30 years) who addressed to the clinic during the period from 2010 to 2014 with the symptoms of recurrent anterior shoulder instability. A risk group has been defined with alleged glenoid dysplasia in the amount of 27 patients who were studied by glenoid dimensions (height, width, area), glenoid version (anteversion, retroversion) and inclination angle of the glenoid. Results. In 22 cases, there has been a change in the normal anatomy of the glenoid as its excessive anteversion, increased angle of inclination, and decrease of its absolute area. Research has identified a pathogenic role of changes in the normal anatomy of the glenoid because recurrence of chronic instability in some cases after surgery, as well as in cases of nontraumatic instability in patients without anatomic lesions. Conclusions. Dysplastic changes of bony structures of the shoulder represent the risk factor for recurrent instability and can serve as one of the causes of recurrence after surgical treatment. When choosing a treatment strategy in patients of modern population is advisable to suggest the possible presence of dysplastic changes glenoid. In the event of recurrence after surgical treatment is shown holding computerized tomography to rule out dysplastic changes.

About the authors

V. M. Prokhorenko

Novosibirsk Medical State University

Author for correspondence.
Email: noemail@neicon.ru
Russian Federation

P. V. Filipenko

6th Military Hospital of the Russia MIA

Email: doctorfilipenko@gmail.com
Russian Federation

S. M. Fomenko

Novosibirsk Research Institute of Traumatology and Orthopedics

Email: noemail@neicon.ru
Russian Federation

N. N. Plotnikova

Novosibirsk Research Institute of Traumatology and Orthopedics

Email: noemail@neicon.ru
Russian Federation

References

  1. Мицкевич В.А. Нестабильность плечевого сустава. Consilium Medicum. 2004; 6(2):87-92.
  2. Свердлов Ю.М. Травматические вывихи и их лечение. М.: Медицина, 1978. 200 с.
  3. Тихилов Р.М., Доколин С.Ю., Кузнецов И.А., Трачук А.П., Бурулев А.Л., Михайлова А.М., Захаров К.И. Отдаленные результаты артроскопического лечения рецидивирующей нестабильности плечевого сустава. Травматология и ортопедия России. 2011; (1):5-13.
  4. Barden J.M., Balyk R., Raso VJ., Moreau M., Bagnall K. Atypical shoulder muscle activation in multidirectional instability. Clin Neurophysiol. 2005; 116(8):1846-1857.
  5. Burkhart S.S., De Beer J.F. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Anhroscopy. 2000; 6:677-694.
  6. Churchill R.S., Brems J.J., Kotschi H. Glenoid size, inclination, and version: an anatomic study. J Shoulder Elbow Surg. 2001; 10:327-332.
  7. Friedman R.J., Hawthorne K.B., Genez B.M. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am. 1992; 74:1032-1037.
  8. Itoi E., Hatakeyama Y., Sato T., Kido T., Minagawa H., Yamamoto N., Wakabayashi I., Nozaka K. Immobilization in external rotation after shoulder dislocation reduces the risk of recurrence. A randomized controlled trial. J Bone Joint Surg Am. 2007; 89(10):2124-2131.
  9. Kwon Y.W., Powell K.A., Yum J.K., Brems J.J., Iannotti J.P. Use of threedimensional computed tomography for the analysis of the glenoid anatomy. J Shoulder Elbow Surg. 2005; 14:85-90.
  10. Lo I.K., Parten P.M., Burkhart S.S. The inverted pear glenoid: An indicator of significant glenoid bone loss. Arthroscopy. 2004; 20:169-174.
  11. Nyffeler R.W., Jost B., Pfirrmann C.W., Gerber C. Measurement of glenoid version: conventional radiographs versus computed tomography scans. J Shoulder Elbow Surg. 2003; 12:493-496.
  12. Ogston J.B., Ludewig P.M. Differences in 3-dimensional shoulder kinematics between persons with multidirectional instability and asymptomatic controls. Am J Sports Med. 2007; 35(8):1361-1370.
  13. Piasecki D.P., Verma N.N., Romeo A.A. еt al. Gleonoid bone deficiency in recurrent shoulder instability: diagnosis and management. J Am Acad Orthop Surg. 2009; 17: 482-493.
  14. Provencher M.T., Frank R.M., LeClere L.E., Metzger P.D. The Hill-Sachs lesion: diagnosis, classification, and management. J Am Acad Orthop Surg. 2012; 20: 242-252.
  15. Rowe C.R. Prognosis in dislocations of the shoulder. J Bone Joint Surg. 1956; 38A:957-977.
  16. Rowe C.R., Patel D., Southmayd W.W. The Bankart procedure: A long-term end-result study. J Bone Joint Surg. 1978; 60-A(1):1-16.
  17. Sienbach L.S., Chung C.B. MRI of the upper extremity: shoulder, elbow, wrist and hand. Section III Shoulder. Philadelphia: Lippincott Williams & Wilkins, 2010.
  18. Soslowsky L.J., Flatow E.L., Bigliani L.U., Mow VC. Articular geometry of the glenohumeral joint. Clin Orthop Relat Res. 1992; 181-190.
  19. Spatschil A., Landsiedl F, Anderl W. et al. Posttraumatic anterior-inferior instability of the shoulder : arthroscopic findings and clinical correlations. Arch Orthop Trauma Surg. 2005; 11:1-6.
  20. Taylor D.C., Arciero R.A. Pathologic changes associated with shoulder dislocations: Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations. AmJ Sports Med. 1997; 25:306-311.
  21. Thomas S.C., Matsen FA. III. An approach to the repair of avulsion of the glenohumeral ligaments in the management of traumatic anterior glenohumeral instability. J Bone Joint Surg Am. 1989; 71:506-513.

Statistics

Views

Abstract: 399

Dimensions

Article Metrics

Metrics Loading ...

PlumX


Copyright (c) 2015



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies