Glenoid track evaluation by a validated finite-element shoulder numerical model

Pécora, José Otávio Reggi; Neves, Alexandre T.; Roesler, Carlos Rodrigo de Mello; Fancello, Eduardo Alberto; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emílio Conforto; Assunção, Jorge Henrique; Neto, Arnaldo Amado Ferreira

doi:10.1016/j.otsr.2020.03.004

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…When he arrived at our emergency room, X-ray and CT scan of the shoulder showed a displaced Ideberg type III fracture of the glenoid, associated with a grade 3 acromioclavicular dislocation. The fracture marginally involved the upper portion of the glenoid; however, in accordance with the biomechanical studies conducted by Pècora et al 9 , it is precisely in this area that the greatest pressure is exerted by the head of the humerus when the limb is at 60° of abduction. Despite the minimal joint involvement, we therefore decided to proceed with surgical treatment.…”

Section: Case Reportsupporting

confidence: 82%

Osteosynthesis of Ideberg type III glenoid fracture with retroclavicular cannulated percutaneous screw

et al. 2021

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In this article we report a 74 year old patient with Ideberg-type III fracture who was treated with indirect reduction and fixation. The patient was a sportive biker who suffered from a high energy trauma (road accident). X-ray revealed a scapula fracture, and only after a CT-Scan we could confirm the fracture type (Ideberg-type III glenoid fracture). The patient was operated and re-evaluated at follow-up. During the surgery we prefered not to access intra-articular due to the low joint involvement. He was able to resume his daily activities at two months postoperatively. At three months ASES Score was 91.5; Constant Score was 71 (vs 96 of unaffected arm). The patient revealed to be satisfied with the treatment, moreover the clinical results are encouraging in view of further improvements in the following months.

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Section: Case Reportsupporting

confidence: 82%

Osteosynthesis of Ideberg type III glenoid fracture with retroclavicular cannulated percutaneous screw

et al. 2021

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“…These clinical findings indicated that the conclusion from the previous landmark study 33 was perhaps worth reconsidering, and alternative methods for determining the glenoid track may be more clinically accurate. From the experimental point of view, the Omori et al study, like all other studies measuring the glenoid track width, 16,35,47,48 was also conducted only under static conditions because of methodologic limitations, which hardly simulate the actual mechanism of traumatic dislocation during motion. 7,29 To the best of our knowledge, the glenoid track width has not been investigated under dynamic conditions so far.…”

Section: -In-5mentioning

confidence: 99%

Glenoid Track Width Is Smaller Under Dynamic Conditions: An In Vivo Dual-Fluoroscopy Imaging Study

Wang

et al. 2022

Am J Sports Med

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Background: The glenoid track concept has been widely used to assess the risk of instability due to bipolar bone loss. The glenoid track width was commonly used as 83% of the glenoid width to determine if a lesion was on-track or off-track. However, the value was obtained under static conditions, and it may not be able to reflect the actual mechanism of traumatic dislocation during motion. Purpose: To compare the glenoid track width under dynamic and static conditions using a dual-fluoroscopic imaging system. Study Design: Controlled laboratory study. Methods: In total, 40 shoulders of 20 healthy volunteers were examined for both dynamic and static tests within a dual-fluoroscopic imaging system at 5 different arm positions: 30°, 60°, 90°, 120°, and 150° of abduction, keeping the shoulder at 90° of external rotation. The participants performed a fast horizontal arm backswing for dynamic tests while keeping their arm in maximum horizontal extension for static tests. Computed tomography scans were used to create 3-dimensional models of the humerus and scapula for 2-dimensional to 3-dimensional image registration. Magnetic resonance imaging scans were obtained to delineate the medial margin of the rotator cuff insertion. The glenoid track width was measured as the distance from the anterior rim of the glenoid to the medial margin of the rotator cuff insertion and compared between static and dynamic conditions. Results: The mean glenoid track widths at 30°, 60°, 90°, 120°, and 150° of abduction were significantly smaller under dynamic conditions (88%, 81%, 72%, 69%, and 68% of the glenoid width) than those under static conditions (101%, 92%, 84%, 78%, and 77% of the glenoid width) (all P < .001). The glenoid track width significantly decreased with the increasing abduction angles in the range of 30° to 120° under static conditions (all P < .003) and 30° to 90° under dynamic conditions (all P < .001). Conclusion: A smaller dynamic-based value should be considered for the glenoid track width when distinguishing on-track/off-track lesions. Clinical evidence is needed to establish the superiority of the dynamic-based value over the static-based value as an indicator for augmentation procedures. Clinical Relevance: Some off-track lesions might be misclassified as on-track lesions when the original commonly used static-based value of 83% is used as the glenoid track width.

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“…O glenoid track permite uma avaliação combinada das lesões da cavidade glenoidal e de Hill-Sachs 7 , com as mesmas caracterizadas como on-track ou off-track . 3 Tal conceito foi ratificado por modelo de elementos finitos 8 e acredita-se que essa avaliação pode prever lesões com maior risco de falha após reparo artroscópico de Bankart isolado. 3 …”

Section: Introductionunclassified

“…6 The glenoid track allows a combined evaluation of glenoidal cavity and Hill-Sachs 7 lesions, with them being characterized as on-track or off-track. 3 This concept was ratified by the finite element model, 8 and it is believed that this evaluation may predict lesions with a higher risk of failure after arthroscopic repair of isolated Bankart. 3 This concept has been widely used to assist in the choice of treatment, with several biomechanical studies demonstrating its importance.…”

Section: Introductionmentioning

confidence: 99%

Validação clínica do conceito de glenoid track na instabilidade glenoumeral anterior

Gracitelli

Lobo

Malavolta

et al. 2022

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Avaliar a correlação do conceito de glenoid track e da perda óssea da cavidade glenoidal com a taxa de recidiva de luxação e pontuação na escala de Rowe. Métodos Estudo retrospectivo que aferiu o glenoid track e a perda óssea da cavidade glenoidal por ressonância magnética pré-operatória. Foram incluídos pacientes submetidos a reparo artroscópico primário de Bankart anterior. Não foram incluídos pacientes com perda óssea da cavidade glenoidal maior que 21%, rotura do manguito rotador, fratura de cintura escapular, instabilidade posterior ou multidirecional. A pontuação pela escala de Rowe foi o desfecho primário, e a taxa de recidiva foi o desfecho secundário. Resultados Cento e dois pacientes foram incluídos. A recidiva foi relatada por 8 pacientes (7,8%). Quatro pacientes (50%) do grupo com recidiva apresentaram lesão da cavidade glenoidal maior que 13,5% contra 24 (25,5%) do grupo sem recidiva (p = 0,210), com valor preditivo negativo de 94,6%. Três pacientes (37,5%) do grupo com recidiva foram considerados off-track, contra 13 (13,8%) do grupo sem recidiva (p = 0,109), com valor preditivo negativo de 94,2%. Pacientes com valor absoluto do glenoid track menor ou igual a 1,5 mm tiveram piores resultados em relação ao grupo com recidiva, sendo que 6 pacientes (75%) apresentaram recidiva (p = 0,003). Conclusão Lesão off-track e perda óssea da cavidade glenoidal maior que a subcrítica não apresentam relação significativa com a taxa de recidiva e a pontuação de Rowe, apesar do alto valor preditivo negativo. O corte do valor absoluto do glenoid track em 1,5 mm apresentou relação significativa com a taxa de recidiva.

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Glenoid track evaluation by a validated finite-element shoulder numerical model

Cited by 9 publications

References 18 publications

Osteosynthesis of Ideberg type III glenoid fracture with retroclavicular cannulated percutaneous screw

Osteosynthesis of Ideberg type III glenoid fracture with retroclavicular cannulated percutaneous screw

Glenoid Track Width Is Smaller Under Dynamic Conditions: An In Vivo Dual-Fluoroscopy Imaging Study

Validação clínica do conceito de glenoid track na instabilidade glenoumeral anterior

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