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

Moroder, Philipp; Haniel, F.; Quirchmayr, Michael; Schulz, Eva; Eppel, Manfred; Matis, Nicholas; Auffarth, Alexander; Resch, Herbert

doi:10.1186/s12891-016-1210-9

Cited by 6 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, a linear relationship exists between the effective depth of the glenoid concavity and the stability ratio. The clinical implications of a pathological loss of bone concavity were further studied by Moroder et al 21,22 and Peltz et al, 23 whose studies established a correlation between the loss of glenoid concavity and instability: in fact, both in traumatic and atraumatic shoulder instability, the glenoid displayed a flatter morphology and a higher radius of curvature (ROC) when compared to healthy volunteers with no history of shoulder pathology. In addition, ROC in the AP direction generally appeared greater than ROC in the supero-inferior direction, confirming previously published data on glenoid morphology, 24 which could explain why a higher degree of instability is present in the AP direction compared to all others.…”

Section: Glenohumeral Stability: the ‘Bony Factors’mentioning

confidence: 99%

The role of bone in glenohumeral stability

2018

View full text Add to dashboard Cite

Shoulder stability depends on several factors, either anatomical or functional. Anatomical factors can be further subclassified under soft tissue (shoulder capsule, glenoid rim, glenohumeral ligaments etc) and bony structures (glenoid cavity and humeral head).Normal glenohumeral stability is maintained through factors mostly pertaining to the scapular side: glenoid version, depth and inclination, along with scapular dynamic positioning, can potentially cause decreased stability depending on the direction of said variables in the different planes. No significant factors in normal humeral anatomy seem to play a tangible role in affecting glenohumeral stability.When the glenohumeral joint suffers an episode of acute dislocation, either anterior (more frequent) or posterior, bony lesions often develop on both sides: a compression fracture of the humeral head (or Hill–Sachs lesion) and a bone loss of the glenoid rim. Interaction of such lesions can determine ‘re-engagement’ and recurrence.The concept of ‘glenoid track’ can help quantify an increased risk of recurrence: when the Hill–Sachs lesion engages the anterior glenoid rim, it is defined as ‘off-track’; if it does not, it is an ‘on-track’ lesion. The position of the Hill–Sachs lesion and the percentage of glenoid bone loss are critical factors in determining the likelihood of recurrent instability and in managing treatment.In terms of posterior glenohumeral instability, the ‘gamma angle concept’ can help ascertain which lesions are prone to recurrence based on the sum of specific angles and millimetres of posterior glenoid bone loss, in a similar fashion to what happens in anterior shoulder instability.Cite this article: EFORT Open Rev 2018;3:632-640. DOI: 10.1302/2058-5241.3.180028

show abstract

Section: Glenohumeral Stability: the ‘Bony Factors’mentioning

confidence: 99%

The role of bone in glenohumeral stability

2018

View full text Add to dashboard Cite

show abstract

“…The authors proved that constitutional differences in glenoid shape led to significant biomechanical implications. In addition, they derived the bony shoulder stability ratio (BSSR), a mathematical approximation of the SR independent of defect size [19][20][21]. In principle, the BSSR is based on measurements of the bony structure and can be computed from CT data by measuring the glenoid depth and the sphere radius of the humeral head.…”

Section: Introductionmentioning

confidence: 99%

Glenoid concavity has a higher impact on shoulder stability than the size of a bony defect

Wermers

Schliemann

Raschke

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Surgical treatment of shoulder instability caused by anterior glenoid bone loss is based on a critical threshold of the defect size. Recent studies indicate that the glenoid concavity is essential for glenohumeral stability. However, biomechanical proof of this principle is lacking. The aim of this study was to evaluate whether glenoid concavity allows a more precise assessment of glenohumeral stability than the defect size alone. Methods The stability ratio (SR) is a biomechanical estimate of glenohumeral stability. It is defined as the maximum dislocating force the joint can resist related to a medial compression force. This ratio was determined for 17 human cadaveric glenoids in a robotic test setup depending on osteochondral concavity and anterior defect size. Bony defects were created gradually, and a 3D measuring arm was used for morphometric measurements. The influence of defect size and concavity on the SR was examined using linear models. In addition, the morphometrical-based bony shoulder stability ratio (BSSR) was evaluated to prove its suitability for estimation of glenohumeral stability independent of defect size. Results Glenoid concavity is a significant predictor for the SR, while the defect size provides minor informative value. The linear model featured a high goodness of fit with a determination coefficient of R2 = 0.98, indicating that 98% of the SR is predictable by concavity and defect size. The low mean squared error (MSE) of 4.2% proved a precise estimation of the SR. Defect size as an exclusive predictor in the linear model reduced R2 to 0.9 and increased the MSE to 25.7%. Furthermore, the loss of SR with increasing defect size was shown to be significantly dependent on the initial concavity. The BSSR as a single predictor for glenohumeral stability led to highest precision with MSE = 3.4%. Conclusion Glenoid concavity is a crucial factor for the SR. Independent of the defect size, the computable BSSR is a precise biomechanical estimate of the measured SR. The inclusion of glenoid concavity has the potential to influence clinical decision-making for an improved and personalised treatment of glenohumeral instability with anterior glenoid bone loss.

show abstract

“…Decreased glenoid depth results in a loss of concavity in the glenoid. This can reduce the compression applied by the rotator cuff, which is one of the primary stabilizers of the shoulder [17]. The BSSR measurement found by Moroder et al is a calculation method that only considers bone structure [2].…”

Section: Discussionmentioning

confidence: 99%

Effect of Glenohumeral Joint Bone Morphology on Anterior Shoulder Instability: A Case-Control Study

Kıvrak

Ulusoy²

2023

JCM

View full text Add to dashboard Cite

Purpose: Glenohumeral joint compatibility and bone morphology are among the most critical factors in shoulder stabilization. Our study investigated the effect of the bone morphological structure of the shoulder joint on anterior shoulder dislocation. Methods: In our study, people with a history of shoulder dislocation were selected as the patient group. In the control group, patients with shoulder MRIs for any reason and no history of shoulder dislocation were included. Those who have a fracture around the shoulder, a congenital deformity in the shoulder region, arthrosis of the shoulder, those whose MRI images cannot be measured, those with Hill-Sachs lesion, connective tissue diseases (such as Ehler Danlos), who are unsure of their diagnosis, or who have incomplete and incorrect suspicious information in their patient file have been excluded. In our retrospective case-control study, glenoid width, glenoid height, glenoid’s height-to-width ratio, glenoid’s depth, glenoid’s version, glenoid’s inclination, humerus radius of curvature, glenoid radius of curvature, and bony shoulder stability ratio were measured on MRI images of the patients. The sample size for each group was determined using a power analysis method. The intra-class coefficient (ICC) assessed interobserver and intraobserver reliability. Results: A total of 80 patients, 40 each in the control and patient groups, were included in the study. Glenoid width was measured as 24.27 ± 1.58 in the patient group, 25.61 ± 1.72 in the control group; glenoid height was as measured 36.49 ± 2.26 in the patient group, 36.74 ± 1.99 in the control group; height-to-width ratio was measured as 1.5 ± 0.08 in the patient group, 1.43 ± 0.05 in the control group; glenoid version was as measured −0.53 ± 1.17 in the patient group, −1.44 ± 1.1 in the control group; glenoid inclination was measured as 1.44 ± 3.93 patient group, 2.64 ± 3.81 in the control group; glenoid depth was measured as 1.69 ± 0.41 in the patient group, 2.12 ± 0.53 in the control group; humerus radius of curvature was measured as 29.70 ± 6.76 in the patient group, 24.98 ± 3.22 in the control group; glenoid axial radius of curvature was measured as 61.8 ± 13.52 in the patient group, 52.53 ± 15.69 in the control group; glenoid coronal radius of curvature was measured as 43.01 ± 7.47 in the patient group, 37.74 ± 6.89 in the control group; the bony shoulder stability ratio was measured as 0.35 ± 0.06 in the patient group and 0.44 ± 0.06 in the control group. In the statistical evaluation, the glenoid width (p < 0.001), the glenoid height/width ratio (p < 0.001), the glenoid version (p < 0.001), the depth of the glenoid cavity (p < 0.001), and the radius of curvature measurements of the humeral head (p < 0.001) and the glenoid (axial, p < 0.007; coronal, p < 0.001) were found to be significantly different. Glenoid height and inclination were similar in both groups. Conclusions: The detection of bone morphological features that constitute risk factors for shoulder dislocations plays an important role in preventing shoulder dislocations. In this way, it provides essential data on personalized rehabilitation programs and treatment selection for recurrent dislocations.

show abstract

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

Cited by 6 publications

References 15 publications

The role of bone in glenohumeral stability

The role of bone in glenohumeral stability

Glenoid concavity has a higher impact on shoulder stability than the size of a bony defect

Effect of Glenohumeral Joint Bone Morphology on Anterior Shoulder Instability: A Case-Control Study

Contact Info

Product

Resources

About