Acromion morphology is associated with glenoid bone loss in posterior glenohumeral instability

被引：10

作者：

Livesey, Michael G. ^{[1
]}

Bedrin, Michael D. ^{[2
]}

Baird, Michael D. ^{[2
]}

Tran, Andrew ^{[1
]}

Weir, Tristan B. ^{[1
]}

Hasan, S. Ashfaq ^{[1
]}

Gilotra, Mohit N. ^{[1
]}

Kilcoyne, Kelly G. ^{[2
]}

Dickens, Jonathan F. ^{[2
,3
,4
,5
]}

机构：

[1] Univ Maryland, Med Ctr, Baltimore, MD USA

[2] Uniformed Serv Univ Hlth Sci, Dept Orthopaed Surg, Walter Reed Natl Mil Med Ctr, Bethesda, MD USA

[3] Duke Univ, Dept Orthopaed, Durham, NC USA

[4] Gothenburg Univ, Inst Clin Sci, Sahlgrenska Acad, Dept Orthopaed, Gothenburg, Sweden

[5] Walter Reed Natl Mil Med Ctr, 3475 Erwin Rd, Durham, NC 27705 USA

来源：

JOURNAL OF SHOULDER AND ELBOW SURGERY | 2023年 / 32卷 / 09期

关键词：

Shoulder; acromion; acromion morphology; glenohumeral instability; posterior shoulder instability; glenoid bone loss; SHOULDER INSTABILITY; EPIDEMIOLOGY;

D O I：

10.1016/j.jse.2023.03.005

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: The acromion morphology in a shoulder with posterior instability differs from that of a shoulder without glenohumeral instability. Specifically, the acromion with a flatter sagittal tilt, greater posterior acromial height, and less posterior coverage is associated with posterior instability. However, the association between acromion morphology and glenoid bone loss (GBL) in the setting of posterior glenohumeral instability has not previously been investigated. The purpose of this study was to determine whether acromial morphology influences the extent or pattern of posterior GBL in a cohort of patients with posterior glenohumeral instability. Methods: This multicenter retrospective study identified 89 shoulders with unidirectional posterior glenohumeral instability. Total area GBL was measured using the best-fit circle method on magnetic resonance imaging (MRI). Shoulders were divided into 3 groups: (1) no GBL (n = 30), (2) GBL 0%-13.5% (n = 45), or (3) GBL > 13.5% (n = 14). Acromion measurements were performed on MRI and included acromial tilt, posterior acromial height, anterior acromial coverage, and posterior acromial coverage. Results: Patients without GBL had a steeper acromial tilt (58.5 degrees +/- 1.4 degrees) compared with those with 0%-13.5% GBL (64.3 degrees +/- 1.5 degrees) or GBL >= 13.5% (67.7 degrees +/- 1.8 degrees) (P =.004). Patients without GBL also had greater posterior coverage (65.4 degrees +/- 1.7 degrees) compared with those with GBL (60.3 degrees +/- 1.4 degrees) (P =.015). Posterior acromion height was not significantly different among groups. Conclusion: The results demonstrate that an acromion with a flatter sagittal tilt and less posterior coverage is associated with GBL in the setting of posterior glenohumeral instability. This is important to consider as posterior GBL has been identified as a risk factor for failure of posterior soft tissue-stabilizing procedures. Level of evidence: Anatomy Study; Imaging (c) 2023 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.

引用

页码：1850 / 1856

页数：7

共 20 条

[1] Defining Critical Glenoid Bone Loss in Posterior Shoulder Capsulolabral Repair [J].