Anterior Shoulder Instability Is Associated With an Underlying Deficiency of the Bony Glenoid Concavity

Moroder, Philipp; Ernstbrunner, Lukas; Pomwenger, Werner; Oberhauser, Florian; Hitzl, Wolfgang; Tauber, Mark; Resch, Herbert; Moroder, Rudi

doi:10.1016/j.arthro.2015.02.009

Cited by 61 publications

(117 citation statements)

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“…Based on the glenoid concavity depth and radius measured on a standarized axial imaging plane [7] on preoperative, postoperative, and 1-year follow-up CT scans the BSSR was calculated utilizing a previously published and validated mathematical formula [10]. The preoperative CT scans revealed a glenoid concavity depth of 0.7 mm and a BSSR of 11.3 % compared to 3.1 mm and 40.3 % measured on the unaffected contralateral side (Fig.…”

Section: Case Presentationmentioning

confidence: 99%

“…A loss of glenoid concavity compromises the concavity compression exerted by the rotator cuff, which is the main stabilizing mechanism of the shoulder in mid-range of motion [5, 8, 9]. These changes in stability due to morphological alterations of the bony glenoid concavity can be mathematically quantified in vivo by calculating the Bony Shoulder Stability Ratio (BSSR) based on CT measurements [10] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

“…1Schematic drawings of a gleno-humeral joint with illustrated translational force (T), compressive force (C), resulting joint force vector (R), joint radius (r), and concavity depth (d). The geometrical measurements and force vectors can be used to calculate the Bony Shoulder Stability Ratio (BSSR) as previously described [10]…”

Section: Introductionmentioning

confidence: 99%

“…The geometrical measurements and force vectors can be used to calculate the Bony Shoulder Stability Ratio (BSSR) as previously described [10]…”

Section: Introductionmentioning

confidence: 99%

“…The biomechanical effects of arthoscopic mobilization, reduction and percutaneous screw fixation of the bony fragment on the morphology of the glenoid concavity and the resulting BSSR are analyzed according to a previously published method [10] and the clinical outcome is reported.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Effect of glenoid concavity loss on shoulder stability- a case report in a professional wrestler

Moroder

Haniel

Quirchmayr

et al. 2016

BMC Musculoskelet Disord

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BackgroundCurrent glenoid defect measurement techniques only quantify bone loss in terms of defect diameter or surface. However, the glenoid depth plays an important role in shoulder stabilization by means of concavity compression.Case presentationWe present a case of a professional wrestler who suffered from anterior shoulder instability after sustaining a bony Bankart lesion without loss of glenoid surface area but flattening of the concavity due to medialization of the fragment. The patient’s glenoid concavity was reconstructed arthroscopically by reduction and percutaneous screw fixation of the bony fragment along with a capsulo-ligamentous shift. Changes of the glenoid concavity with according alterations in the Bony Shoulder Stability Ratio (BSSR) were analyzed on pre-op, post-op, and follow-up CT scans. Postoperative CT scans revealed a deepened concavity (3.3 mm) and improved BSSR (46.1 %) compared to pre-op scans (0.7 mm; 11.3 %). Follow-up CT scans showed a slight remodeling of the glenoid concavity (3.2 mm) with steady BSSR (44.7 %).ConclusionThis case shows that the passive stabilizing effect of the glenoid can be compromised by loss of concavity despite the absence of loss of articular surface. Therefore, addressing the concavity loss and resulting reduction of the BSSR is recommended in these cases. Bony Bankart repair was successful in restoring the BSSR of the patients shoulder as determined by mathematical calculations based on CT scans.

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Section: Case Presentationmentioning

confidence: 99%