Back to Search
Start Over
Coracoacromial morphology: a contributor to recurrent traumatic anterior glenohumeral instability?
- Source :
-
Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2019 Jul; Vol. 28 (7), pp. 1316-1325.e1. Date of Electronic Publication: 2019 Mar 28. - Publication Year :
- 2019
-
Abstract
- Background: Although scapular morphology contributes to glenohumeral osteoarthritis and rotator cuff disease, its role in traumatic glenohumeral instability remains unknown. We hypothesized that coracoacromial and glenoid morphology would differ between healthy subjects and patients with recurrent traumatic anterior shoulder instability.<br />Methods: Computed tomography scans of 31 cadaveric control scapulae and 54 scapulae of patients with recurrent traumatic anterior shoulder instability and Hill-Sachs lesions were 3-dimensionally reconstructed. Statistical shape modeling identified the modes of variation between the scapulae of both groups. Corresponding measurements quantified these modes in relation to the glenoid center (linear offset measures), defined by the best-fit circle of the inferior glenoid, or the glenoid center plane (angles), which bisects the glenoid longitudinally. Distances were normalized for glenoid size.<br />Results: Compared with controls, the unstable coracoids were shorter (P = .004), with a more superior and medial offset of the tip (mean difference [MD], 7 and 3 mm, respectively; P < .001) and an origin closer to the 12-o'clock position (MD, 6°; P < .001). The unstable scapular spines originated closer to the 9-o'clock position (MD, 4°; P = .012), and the unstable acromions were more vertically oriented (MD, 6°; P < .001). The unstable glenoids had an increased height-width index (MD, 0.04; P = .021), had a flatter anterior-posterior radius of curvature (MD, 77 mm; P < .001), and were more anteriorly tilted (MD, 5°; P = .005).<br />Conclusions: Coracoacromial and glenoid anatomy differs between individuals with and without recurrent traumatic anterior shoulder instability. This pathologic anatomy is not addressed by current soft-tissue stabilization procedures and may contribute to instability recurrence.<br /> (Copyright © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Acromion diagnostic imaging
Acromion pathology
Adolescent
Adult
Aged
Bankart Lesions pathology
Cadaver
Case-Control Studies
Coracoid Process diagnostic imaging
Coracoid Process pathology
Female
Glenoid Cavity diagnostic imaging
Glenoid Cavity pathology
Humans
Imaging, Three-Dimensional
Joint Instability pathology
Male
Middle Aged
Recurrence
Retrospective Studies
Rotator Cuff pathology
Scapula pathology
Shoulder Joint pathology
Tomography, X-Ray Computed
Young Adult
Bankart Lesions diagnostic imaging
Joint Instability diagnostic imaging
Scapula diagnostic imaging
Shoulder Joint diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1532-6500
- Volume :
- 28
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of shoulder and elbow surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30928394
- Full Text :
- https://doi.org/10.1016/j.jse.2019.01.009