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Measuring Bone Loss in the Unstable Shoulder: Understanding and Applying the Track Concept.
- Source :
-
Sports medicine and arthroscopy review [Sports Med Arthrosc Rev] 2020 Dec; Vol. 28 (4), pp. 153-158. - Publication Year :
- 2020
-
Abstract
- An interesting international debate has been developed over the past 10 years (the last decade) surrounding the surgical procedure for recurrent anteroinferior instability and a definitive consensus is lacking on the factors which favor one technique over another, especially when bone loss is present (soft tissue vs. bone block). Glenoid bone loss is commonly observed in the shoulder with anterior instability, and it is difficult to evaluate the shape of the glenoid using plain radiograph, therefore, computed tomography or intraoperative observation is recommended for accurate assessment of glenoid bone loss and Hill-Sachs lesion. When we consider the bony defect of the glenoid as a risk factor for surgical failure, it is crucial to take into consideration the features of a concomitant Hill-Sachs lesion. However, all the previous reports focusing on the size of the Hill-Sachs lesion or on the glenoid bone loss in isolation, overlook the interaction of the 2 lesions through the arc of range of motion and how this may influence instability. The glenoid track is the first model to determine, in a dynamic way, how bone loss on both sides of the joint can lead to instability. The glenoid track is a zone of contact created by the glenoid on the humeral articular surface when the arm is moved along the end-range of motion (abduction and external rotation). The use of the glenoid track concept can potentially help guide surgical decision-making.
- Subjects :
- Algorithms
Arthroscopy
Humans
Joint Instability diagnostic imaging
Joint Instability physiopathology
Joint Instability surgery
Magnetic Resonance Imaging
Radiography
Range of Motion, Articular
Shoulder Dislocation diagnostic imaging
Shoulder Dislocation physiopathology
Shoulder Dislocation surgery
Shoulder Joint diagnostic imaging
Shoulder Joint physiopathology
Shoulder Joint surgery
Tomography, X-Ray Computed
Joint Instability pathology
Shoulder Dislocation pathology
Shoulder Joint pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1538-1951
- Volume :
- 28
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Sports medicine and arthroscopy review
- Publication Type :
- Academic Journal
- Accession number :
- 33156230
- Full Text :
- https://doi.org/10.1097/JSA.0000000000000293