Kenji Kanazawa1, Yoshihiro Hagiwara2, Nobuaki Kawai3, Takuya Sekiguchi4, Masashi Koide4, Akira Ando5, Hiroyuki Sugaya3, Eiji Itoi4. 1. Department of Orthopaedic Surgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan. 2. Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan. Electronic address: hagi@med.tohoku.ac.jp. 3. Shoulder & Elbow Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan. 4. Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan. 5. Department of Orthopaedic Surgery, Matsuda Hospital, Sendai, Miyagi, Japan.
Abstract
BACKGROUND: Evaluation of range of motion (ROM) restriction before treatment of shoulder disorders is important for predicting the final functional outcomes. The purpose of this study was to investigate correlations of thickness of the coracohumeral ligament (CHL) and ROM restriction in patients with recurrent anterior glenohumeral instability. METHODS: Between January 2005 and March 2015, 181 shoulders (137 male and 44 female patients; mean age, 29.3 years) with recurrent anterior glenohumeral instability treated with an arthroscopic Bankart repair were enrolled in this study. We evaluated preoperative ROM, thickness of the CHL, and obliteration of the subcoracoid fat triangle on magnetic resonance arthrography. ROM measurements, including forward flexion (FF), external rotation with the arm at the side (ER), and hand behind the back (HBB), were made in a standing position. RESULTS: There were significant negative correlations between FF and age (P < .001) and between HBB and age (P < .001) but not between ER and age (P = .11). The thickness of the CHL significantly increased with age (P < .001). FF, ER, and HBB were significantly restricted in patients with obliteration compared with those without obliteration (P < .001, P = .004, P < .001, respectively). CONCLUSIONS: Obliteration of the subcoracoid fat triangle and the thickness of the CHL positively correlated with ROM restrictions, and these changes were greater with age in patients with recurrent anterior glenohumeral instability.
BACKGROUND: Evaluation of range of motion (ROM) restriction before treatment of shoulder disorders is important for predicting the final functional outcomes. The purpose of this study was to investigate correlations of thickness of the coracohumeral ligament (CHL) and ROM restriction in patients with recurrent anterior glenohumeral instability. METHODS: Between January 2005 and March 2015, 181 shoulders (137 male and 44 female patients; mean age, 29.3 years) with recurrent anterior glenohumeral instability treated with an arthroscopic Bankart repair were enrolled in this study. We evaluated preoperative ROM, thickness of the CHL, and obliteration of the subcoracoid fat triangle on magnetic resonance arthrography. ROM measurements, including forward flexion (FF), external rotation with the arm at the side (ER), and hand behind the back (HBB), were made in a standing position. RESULTS: There were significant negative correlations between FF and age (P < .001) and between HBB and age (P < .001) but not between ER and age (P = .11). The thickness of the CHL significantly increased with age (P < .001). FF, ER, and HBB were significantly restricted in patients with obliteration compared with those without obliteration (P < .001, P = .004, P < .001, respectively). CONCLUSIONS: Obliteration of the subcoracoid fat triangle and the thickness of the CHL positively correlated with ROM restrictions, and these changes were greater with age in patients with recurrent anterior glenohumeral instability.
Authors: David McKean; Siok Li Chung; Rebecca Te Water Naudé; Bernard McElroy; Jonathan Baxter; Aniruddha Pendse; Joseph Papanikitas; James Teh; Richard Hughes Journal: J Ultrason Date: 2020-12-18