D. Dejour's classification is valid for typing trochlear dysplasia and is particularly useful in separating low-grade from high-grade dysplasia.

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Purpose The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon's geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. Methods A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. Results A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and > 10 years of practice experience, with only 2 case exceptions noted. Conclusion More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe.

Prognostic, Level I.

The acromion index is not different between shoulders with calcifying tendinitis, and partial- or full-thickness rotator cuff tears.

Glenohumeral cartilage lesions are frequently encountered during shoulder arthroscopy, but are not always represented on radiographs. We intended to define the diagnostic value of plain shoulder radiographs in detecting glenohumeral cartilage lesions. The radiographs of 167 patients undergoing shoulder arthroscopy were analyzed for signs of degenerative joint disease. Formal criteria indicating osteoarthritis (osteophytes, joint space narrowing, and sclerosis) were registered and correlated to cartilage lesions diagnosed during shoulder arthroscopy. The intrarater reliabilities were .920 (T.K.) and .953 (M.E.) and the interrater reliabilities were .802 (T.K. 1, M.E. 1), .909 (T.K. 2, M.E. 1), .922 (T.K. 1, M.E. 2), and .953 (T.K. 2, M.E. 2), indicating excellent agreement. There were 35 correct positive, 91 correct negative, 34 false negative, and 7 false positive radiographs. The sensitivity and specificity for any degree of cartilage lesion were 50.7% and 92.9%, respectively, and the positive and negative predictive values were 83.3% and 72.8%, respectively. For third- and fourth-grade cartilage lesions, the sensitivity was 76.0% and the positive and negative predictive values were 73.1% and 93.8%, respectively. While plain radiographs can often detect severe cartilage lesions, the sensitivity and negative predictive value are too low to reliably exclude cartilage lesions overall. In case of doubt, we recommend further radiological workup.

Posterior fracture-dislocations of the shoulder are uncommon and challenging lesions. We present the case of a 76-year-old male patient who sustained a locked posterior humeral head fracture-dislocation during a convulsion. Because more than 40% of the articular surface was involved, preserving the head was not possible. We treated the fracture with a cemented humeral surface replacement. The patient demonstrated good shoulder function and no instability on short-term follow-up. Surface replacement may be a valuable treatment option for fracture-dislocations of the shoulder with articular surface involvement.