Classification of Glenohumeral Joint Instability

Gerber, Christian; Nyffeler, Richard W.

doi:10.1097/00003086-200207000-00009

Cited by 432 publications

(291 citation statements)

References 25 publications

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“…Griffith et al [29] Erosion edge Length of the glenoid rim defect Gerber and Nyffeler [39], Griffith et al [29] R The radius of the inferior glenoid circle Barchilon et al [28] d Perpendicular line from the erosion edge to the centre of the inferior circle…”

Section: Resultsmentioning

confidence: 99%

“…The authors did not compute the reliability of the method; however, our results show that measuring the width and length on 2D-CT is not reliable because it is difficult to determine the exact top of the glenoid. Similar parameters (AP width and erosion edge) were analysed by Gerber and Nyffeler [39], but the main aim of this study was to create a classification of glenohumeral joint instability and not to analyse the reliability of the created method.…”

Section: Discussionmentioning

confidence: 99%

“…1. Then, various parameters of glenoid fossa were measured using the following methods: Gerber and Nyffeler [39], Griffith et al [29], Sugaya et al [41], Barchilon et al [28], Magarelli et al [42] (for description and visualisation of measurements see Table 1 and Fig. 2).…”

Section: D Measurement Methodsmentioning

confidence: 99%

“…These limitations might be solved by the 3D measurement method, but only a few studies have used it to assess the size of a glenoid defect so far [39][40][41] and only one of these assessed the reliability of the new method [40]. Moreover, in all of these studies reproducibility of the parameters was compared to the 2D measurement method.…”

Section: Introductionmentioning

confidence: 99%

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Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Kubicka

Stefaniak

Lubiatowski

et al. 2016

International Orthopaedics (SICOT)

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Purpose The main purpose of this study is to establish which of two methods is more reliable in glenoid assessment for instability in pre-operative planning. Accordingly, we have studied the intra-and inter-observer reliability of glenoid parameters with the use of two-dimensional (2D) and three-dimensional (3D) reconstructed computed tomography (CT) images. Methods One hundred glenoids were measured with the use of 2D-CT and 3D-CT (in 3D orientation) by two independent observers (one experienced and one inexperienced). Measurements were repeated after one week for 30 randomly selected glenoids. Results The intra-class correlation coefficient (ICC) for interobserver reliability was significantly greater for 3D-CT (0.811 to 0.915) than for 2D-CT (0.523 to 0.925). All intra-observer reliability values for 3D-CT were near perfect (0.835 to 0.997), while those for 2D-CT were less reliable (0.704 to 0.960). A dependent t-test showed that, for both observers, almost all glenoid parameters (except R and d) differed significantly (p < 0.05) between 2D and 3D measurement methods. Conclusions Therefore, it can be concluded that 3D glenoid reconstructions are more reliable for glenoid bone loss assessment than 2D-CT. The results suggest that quantifying a glenoid defect with the use of 2D image only-even if performed by an experienced orthopaedic surgeon-is prone to errors. Differences in measurements between and within observers can be explained by plane setting and identifying glenoid rim in 2D -C T. Accordingly, we recommend that glenoid measurements should be performed in 3D orientation using 3D reconstruction obtained from CT images for pre-operative assessments, which are crucial for surgical planning.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: D Measurement Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Kubicka

Stefaniak

Lubiatowski

et al. 2016

International Orthopaedics (SICOT)

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“…As has been shown in our study, a significant reduction of joint volume can be expected in Bankart labral too. One should bear it in mind when dealing with patients without laxity, or when laxity is not the leading factor in avoiding postoperative shoulder stiffness [37]. Cadaveric studies have shown that capsular shrinkage and reducing the joint volume also decrease the glenohumeral translation and rotational movements [18].…”

Section: Discussionmentioning

confidence: 99%

Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

Lubiatowski

Długosz

Ślęzak

et al. 2016

International Orthopaedics (SICOT)

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Purpose The evaluation of glenohumeral joint volume in both unstable (with/without laxity) and stable shoulders (subacromial impingement) and volume reduction potential of arthroscopic techniques: (labral anchor repair vs. capsular shift). Methods Material was based on 133 patients: anterior shoulder instability without laxity (group I, n = 49), with laxity (group II, n = 22) and subacromial impingement (control group, n = 62) operated in 2010-2011. Group I received arthroscopic Bankart repair, group; II -arthroscopic anterior capsular plication, control group -subacromial decompression. Joint volume was measured by fluid aspiration into the syringe via arthroscope, before and after procedure. Then volume reduction potential was calculated. Results The following average values of initial joint volume were recorded: group I -26.8 ml group II -43.7 ml and the control group -25.6 ml with significant differences: impingement vs. instability + laxity (p < 0.00001), impingement vs. instability without laxity (p = 0.0001). There was no significant difference between groups I and II. Joint volume was significantly reduced after labral repair (by average of 37 %, 13.8 ml, p < 0.0001). Capsular shift led to an even greater and more significant volume decrease (61 %, 26.7 ml, p < 0.001). Joint volume in the control group was reduced only by 11 %, 3.8 ml (p = 0.046).Conclusions Patients with unstable shoulders have enlarged joint volume as compared to patients with subacromial impingement. Arthroscopic techniques lead to a significant joint volume reduction, with the most powerful effect for capsular shift. Level of Evidence -Level 2.

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The glenohumeral ligaments: Superior, middle, and inferior: Anatomy, biomechanics, injury, and diagnosis

Fox

Schär

et al. 2021

Clinical Anatomy

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The three glenohumeral ligaments (superior, middle, and inferior) are discrete thickenings of the glenohumeral joint capsule and are critical to shoulder stability and function. Injuries to this area are a cause of significant musculoskeletal morbidity. A literature search was performed by a review of PubMed, Google Scholar, and OVID for all relevant articles published up until 2020. This study highlights the anatomy, biomechanical function, and injury patterns of the glenohumeral ligaments, which may be relevant to clinical presentation and diagnosis. A detailed understanding of the normal anatomy and biomechanics is a necessary prerequisite to understanding the injury patterns and clinical presentations of disorders involving the glenohumeral ligaments of the shoulder.

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Classification of Glenohumeral Joint Instability

Cited by 432 publications

References 25 publications

Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

The glenohumeral ligaments: Superior, middle, and inferior: Anatomy, biomechanics, injury, and diagnosis

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