Imaging of shoulder instability

Filippo, Massimo De; Schirò, Silvia; Sarohia, Dani; Barile, Antonio; Saba, Luca; Cella, Simone; Castagna, Alessandro

doi:10.1007/s00256-020-03459-z

Cited by 10 publications

(12 citation statements)

References 74 publications

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“…The symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion is defined as shoulder instability. 1 Recurrent instability can be caused by traumatic anterior glenohumeral dislocations or subluxations, especially in young contact athlete patients, more so if there is associated bone loss. 2 , 3 Traumatic unidirectional anterior shoulder instability is widely treated by arthroscopic Bankart repair.…”

mentioning

confidence: 99%

Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate

Pathak

Haidermota

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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To demonstrate whether arthroscopic remplissage can achieve good outcomes without significantly impairing shoulder function. Methods: Consecutive patients with recurrent anterior glenohumeral dislocation, glenoid bone loss <20%, and engaging HilleSachs lesion who were operated with arthroscopic Bankart repair and remplissage between 2013 and 2016 were identified. Patients were evaluated clinically for shoulder instability, range of motion, and scored as per Oxford Shoulder Instability Score and University of California at Los Angeles score. The data were analyzed with the paired t test and the Wilcoxon signed rank test, as applicable. For all analyses, statistical significance was set at P < .05. Results: Twenty-four patients were included in the study. The average age of the patients was 30 years (range, 18-47 years), with 91.67% (n ¼ 22) male patients and 8.33% (n ¼ 2) female patients. The range of motion at follow-up was comparable with the normal side, with loss of external rotation of 3.33 (n ¼ 24). Significant improvement was observed in the Oxford Shoulder Instability Score (21.95 vs 41.29, P < 0.001) and University of California at Los Angeles score (18.33 vs 30.29, P < .001). A failure rate of 4.17% (1 patient with a positive apprehension test) was seen. Conclusions: Arthroscopic Bankart repair with the remplissage procedure helps to re-establish stability and achieve good shoulder outcomes for patients with recurrent anterior glenohumeral dislocation and an engaging HilleSachs lesion and without significant glenoid bone loss. Level of Evidence: Level IV, therapeutic.

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confidence: 99%

Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate

Pathak

Haidermota

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Shoulder macro-instability includes different clinical entities [1]. These are classified into two groups following the etiopathogenetic features and possible therapeutic options:…”

Section: Introductionmentioning

confidence: 99%

“…-Traumatic instability/traumatic etiology, unidirectional instability, Bankart lesion, surgery required (TUBS). -Atraumatic instability/atraumatic or minor trauma, multidirectional instability, bilateral, rehabilitation, inferior capsular shift (AMBRI) [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance arthrography in patients with multidirectional instability: could inferior capsulsar width be considered the cornerstone in the diagnosis of non-traumatic shoulder instability?

et al. 2022

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Objectives To provide quantitative anatomical parameters in patients with and without non-traumatic multidirectional instability using MR arthrography (MR-a). Materials and methods One hundred and seventy-six MR-a performed from January 2020 to March 2021 were retrospectively evaluated. Patients were divided according to the presence of clinically diagnosed multidirectional shoulder instability (MDI). Each MR-a was performed immediately after intra-articular injection of 20 ml of gadolinium using the anterior approach. The width of the axillary recess, the width of the rotator interval, and the circumference of the glenoid were measured by three independent radiologists, choosing the average value of the measurements. The difference between the mean values of each of the three parameters between the two study groups was then assessed. Results Thirty-seven patients were included in the study (20 in the MDI group, 17 in the control group). The mean axillary recess width in the MDI group was significantly greater than in the control group (t(33) = 3.15, p = .003); rotator interval width and glenoid circumference measurements were not significantly different (t(35) = 1.75, p = .08 and t(30) = 0,51, p = .6, respectively). Conclusions Inferior capsular redundancy may be an important predisposing factor in MDI, while glenoid circumference is not related to MDI. The relationship between the width of the rotator interval and shoulder instability remains debated.

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“…Preoperative imaging studies are key for decisionmaking and planning (De Filippo et al, 2020;Stefaniak et al, 2020). There are several modalities, but CT scans are the most suitable to evaluate the glenoid bone defect (Zhang et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Estimating Glenoid Fossa width for Instability - related Bone loss with CT Scan in a Chilean Sample

2021

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Glenoid fossa bone loss has been associated with recurrence and failure after glenoid labrum repair for shoulder instability. Quantification of glenoid fossa bone loss is critical for the successful treatment of glenohumeral instability. The aim of this paper was to estimate a linear regression model based on glenoid height in CT scan adjusted for age and sex to calculate glenoid fossa width in a healthy Chilean sample. CT scans of 101 shoulders were reviewed. The mean age was 51.96 years (SD 19.16; range, with 53 females and 48 male patients. Studies with signs of bone loss, instability, fracture, or arthritis were excluded. After 3D-CT reconstruction, the height and width of each glenoid fossa was measured using the Owens methodology. All landmarks for the 2 measurements were placed on the most lateral surface of the glenoid fossa margin. Measurements for all shoulders were recorded by 3 observers and repeated on a subset (n = 20) of shoulders, under blinded conditions, by the same observer, at least 2 weeks after the initial measurements. Descriptive statistics, intraclass correlation and regression coefficients were calculated with Stata BE 17® software. A pvalue of 0.05 was considered significant. A linear regression model was estimated resulting in the formula "Width = 10.97 + 0.02 * Age + 0.41 * Height -1.95 * Sex (1=Female, 0=Male)". This model presented all coefficients with p <0.05 and an adjusted R2 of 0.73. Furthermore, it fulfilled the assumption of linearity, normal distribution of errors, independence of errors, and homoscedasticity. Regarding the intraobserver correlation, ICC was 0.76 for height and 0.91 for width; the interobserver ICC was 0.93 for height and 0.86 for width. A 3D-CT specific formula was developed to predict glenoid fossa width based on height with sufficient accuracy to be clinically valuable.

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Imaging of shoulder instability

Cited by 10 publications

References 74 publications

Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate

Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate

Magnetic resonance arthrography in patients with multidirectional instability: could inferior capsulsar width be considered the cornerstone in the diagnosis of non-traumatic shoulder instability?

Estimating Glenoid Fossa width for Instability - related Bone loss with CT Scan in a Chilean Sample

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