Posterior Shoulder Instability: Does Glenoid Retroversion Predict Recurrence and Contralateral Instability?

Gottschalk, Michael B.; Ghasem, Alex; Todd, Dane C.; Daruwalla, Jimmy H.; Xerogeanes, John W.; Karas, Spero G.

doi:10.1016/j.arthro.2014.10.009

Cited by 56 publications

(37 citation statements)

References 24 publications

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“…P revious reports have shown that glenoid version and morphology are correlated with the presence or absence of glenohumeral stability 1,7,8,33 .…”

Section: Discussionmentioning

confidence: 99%

“…It is conceivable that, if the osseous restraints created by the posterior aspect of the acromion are lacking, recurrent posterior instability starts relatively early in life, without trauma or clinical symptoms, after which the posterior capsular restraints soon become overloaded, resulting in clinically apparent posterior instability. Gottschalk et al 1 that patients with posterior instability had a significantly higher rate of contralateral surgery for posterior instability than those with anterior instability. This could be explained by a more important role of anatomic factors if such factors were found in these cases and if they could be shown to be generally bilateral.…”

Section: Discussionmentioning

confidence: 99%

“…Additional investigation is needed to determine the relevance of these findings for future treatment. n Dominik C. Meyer, MD 1 Lukas Ernstbrunner, MD 1 Glenn Boyce, MD 1 Mohamed A. Imam, MD 1 Rany El Nashar, MD 1 Christian Gerber, MD 1…”

Section: Discussionmentioning

confidence: 99%

“…See Instructions for Authors for a complete description of levels of evidence. R ecurrent posterior glenohumeral instability has been associated with increased glenoid retroversion and dysplasia of the posteroinferior aspect of the glenoid rim [1][2][3] . Anterior glenohumeral instability has been found to be associated not only with anterior glenoid bone loss [4][5][6] but also with deficient depth of the glenoid concavity 7,8 .…”

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confidence: 99%

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Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Meyer

Ernstbrunner

Boyce

et al. 2019

The Journal of Bone and Joint Surgery

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BACKGROUND The purpose of this paper was to determine whether acromial morphology influences anteroposterior shoulder stability. We hypothesized that a more horizontal and higher position of the acromion in the sagittal plane would be associated with posterior instability. METHODS In this retrospective study, patients with unidirectional posterior instability were age and sex-matched to a cohort of patients with unidirectional anterior instability. Both cohorts were compared with a control group of patients with no instability and no degenerative glenohumeral (rotator cuff and/or joint surface) or acromial changes. Measurements on radiographs included posterior acromial tilt, anterior and posterior acromial coverage (AAC and PAC), posterior acromial height (PAH), and the critical shoulder angle (CSA). RESULTS The number of patients enrolled in each instability group was 41, based on a priori power analysis. The control group consisted of 53 shoulders. Of the measured anatomic factors, PAH showed the most significant association with posterior instability (odds ratio [OR] = 1.8; p < 0.001) in the logistic regression model. PAH was significantly greater in the posterior instability group compared with the anterior instability group (30.9 versus 19.5 mm; p < 0.001). With a cutoff value of PAH of 23 mm, the OR for posterior instability was 39. Shoulders with posterior instability were also significantly different from normal shoulders with regard to PAH (p < 0.001), AAC (p < 0.001), and PAC (p < 0.001) whereas, in the shoulders with anterior instability, all of these values except the AAC (p = 0.011) did not differ from those of normal shoulders. CONCLUSIONS Specific acromial morphology is significantly associated with the direction of glenohumeral instability. In shoulders with posterior instability, the acromion is situated higher and is oriented more horizontally in the sagittal plane than in normal shoulders and those with anterior instability; this acromial position may provide less osseous restraint against posterior humeral head translation. A steep "Swiss chalet roof-type" acromion virtually excluded recurrent posterior instability in an albeit relatively small cohort of patients. Additional investigation is needed to determine the relevance of these findings for future treatment. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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“…P revious reports have shown that glenoid version and morphology are correlated with the presence or absence of glenohumeral stability 1,7,8,33 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Meyer

Ernstbrunner

Boyce

et al. 2019

The Journal of Bone and Joint Surgery

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“…Humerus retroversiyonu glenohumeral eklem mekaniğini etkiler. Omuz ekleminin mobilite ve stabilitesi retroversiyon miktarına bağlıdır (10)(11)(12)(13)(14) . Bu çalışmanın amacı, diafiz kırığı sonrası iyileşmiş humerus ile aynı bireyin karşı taraf sağlam humerus versiyon açılarının BT ile değerlendirilmesi ve versiyondaki değişimin fonksiyonel sonuçlara olan etkisinin incelenme-sidir.…”

Section: Discussionunclassified

Does the change of retroversion angle effect the clinical results of conservative treatment of humerus diaphyseal fractures?

Doğan¹,

Caliskan²,

Gencer³

et al. 2019

TERH

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Objective: Retroversion changes, that can be seen after humeral diaphyseal fractures, can play a role on functional results by affecting the mobility and stability of shoulder joint. The aim of this study is to evaluate the retroversion angles of healed humerus by using computed tomography and to examine the effects of retroversion on functional results. Methods: Fifty-two humeral diaphyseal fractures were evaluated retrospectively. Retroversion angles of fractured humerus and contralateral humerus of all patients were measured by computed tomography. Constant Shoulder Scoring (COS) system was used to evaluate functional results. Mann Whitney-U test, Spearman and Pearson Correlation tests were used for statistical analysis. Results: Of the 28 patients included in the study, 14 (50%) were female and 14 (50%) were male. The mean followup period was 23.6 months (range 22-26), with a mean age of 45.14 (range 15-80) years. In 15 patients, the retroversion angle was increased (median 21.46 degrees), and in 13 patients the retroversion angle was decreased (antevert) (median 16.34 degrees). Changes in retroversion angles were not found to be statistically significant (p=0.828). COS values were found to be lower in patients with deeper changes in retroversion angles (p=0.433). Conclusion: Wide retroversion intervals can be obtained in humerus diaphyseal fractures by conservative treatment. This has little effect on clinical functional outcomes.

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Posterior Shoulder Instability and Labral Pathology

O’Reilly

Behrens

Gulbrandsen

et al. 2022

MRI-Arthroscopy Correlations

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Posterior Shoulder Instability: Does Glenoid Retroversion Predict Recurrence and Contralateral Instability?

Cited by 56 publications

References 24 publications

Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Does the change of retroversion angle effect the clinical results of conservative treatment of humerus diaphyseal fractures?

Posterior Shoulder Instability and Labral Pathology

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