Stephen A Parada1, Josef K Eichinger2, Guillaume D Dumont3, Lauren E Burton4, Maggie S Coats-Thomas4, Stephen D Daniels5, Nathan J Sinz5, Matthew T Provencher4, Laurence D Higgins5, Jon J P Warner4. 1. Department of Orthopaedic Surgery, Eisenhower Army Medical Center, Fort Gordon, Georgia, U.S.A.. Electronic address: Stephen.a.parada@gmail.com. 2. Department of Orthopedic Surgery, Madigan Army Medical Center, Tacoma, Washington, U.S.A. 3. Department of Orthopaedic Surgery, University Specialty Clinics, Columbia, South Carolina, U.S.A. 4. Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A. 5. Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
Abstract
PURPOSE: To evaluate glenoid version and humeral subluxation on preoperative multiplanar imaging of patients who underwent surgery for posterior glenohumeral instability compared with a matched group of patients who had shoulder surgery for other pathology. METHODS: All patients over a 2-year period who underwent surgery for posterior instability had preoperative magnetic resonance (MR) imaging or MR arthrogram reviewed. Patients undergoing shoulder surgery for reasons other than instability were identified as a control group and matched by sex, laterality, and age. Measurement of glenoid version and percentage of humeral subluxation was performed by 2 reviewers after completing a tutorial. Reviewers were blinded to diagnosis and to whether or not the patients were in the experimental or control group. RESULTS: There were 41 patients in each group. The average glenoid version in the control group was 5.6° of retroversion (standard deviation [SD] 3.0), and the average humeral subluxation was 54% (SD 5.1%). In the experimental group, the average glenoid version was 8.1° of retroversion (SD 5.0). The average humeral subluxation in the experimental group was 56% (SD 6.8%). Student t test revealed a statistically significant difference in glenoid version (P = .009) but not humeral subluxation (P = .25). Intra- and inter-rater reliability was measured by the intraclass correlation coefficient and found to have an excellent Fleiss rating with regard to both measurements. CONCLUSIONS: Glenoid retroversion is significantly increased in patients with symptomatic posterior labral tears compared with a control group. However, there was no statistically significant difference between the groups with regard to posterior humeral subluxation and, therefore, is not a reliable indicator of the presence or absence of symptomatic posterior shoulder instability. LEVEL OF EVIDENCE: Level III, retrospective comparative study. Published by Elsevier Inc.
PURPOSE: To evaluate glenoid version and humeral subluxation on preoperative multiplanar imaging of patients who underwent surgery for posterior glenohumeral instability compared with a matched group of patients who had shoulder surgery for other pathology. METHODS: All patients over a 2-year period who underwent surgery for posterior instability had preoperative magnetic resonance (MR) imaging or MR arthrogram reviewed. Patients undergoing shoulder surgery for reasons other than instability were identified as a control group and matched by sex, laterality, and age. Measurement of glenoid version and percentage of humeral subluxation was performed by 2 reviewers after completing a tutorial. Reviewers were blinded to diagnosis and to whether or not the patients were in the experimental or control group. RESULTS: There were 41 patients in each group. The average glenoid version in the control group was 5.6° of retroversion (standard deviation [SD] 3.0), and the average humeral subluxation was 54% (SD 5.1%). In the experimental group, the average glenoid version was 8.1° of retroversion (SD 5.0). The average humeral subluxation in the experimental group was 56% (SD 6.8%). Student t test revealed a statistically significant difference in glenoid version (P = .009) but not humeral subluxation (P = .25). Intra- and inter-rater reliability was measured by the intraclass correlation coefficient and found to have an excellent Fleiss rating with regard to both measurements. CONCLUSIONS: Glenoid retroversion is significantly increased in patients with symptomatic posterior labral tears compared with a control group. However, there was no statistically significant difference between the groups with regard to posterior humeral subluxation and, therefore, is not a reliable indicator of the presence or absence of symptomatic posterior shoulder instability. LEVEL OF EVIDENCE: Level III, retrospective comparative study. Published by Elsevier Inc.
Authors: Florian B Imhoff; Roland S Camenzind; Elifho Obopilwe; Mark P Cote; Julian Mehl; Knut Beitzel; Andreas B Imhoff; Augustus D Mazzocca; Robert A Arciero; Felix G E Dyrna Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-06-28 Impact factor: 4.342