Department of Orthopaedics, Catholic University, Rome, Italy.
Am J Sports Med. 2011 Sep;39(9):1870-6. doi: 10.1177/0363546511411699. Epub 2011 Jun 27.
Glenoid bone defect is frequently associated with anterior shoulder instability and is considered one of the major causes of recurrence of instability after shoulder stabilization.
Some risk factors are significantly associated with the presence, size, and type of glenoid bone defect.
Cohort study (prognosis); Level of evidence, 2.
One hundred sixty-one patients affected by anterior shoulder instability underwent morphologic evaluation of the glenoid by computed tomography scans to assess the presence, size, and type of glenoid bone defect (erosion or bony Bankart lesion). Bone loss greater than 20% of the area of the inferior glenoid was considered "critical" bone defect (at risk of recurrence). Outcomes were correlated with the following predictors: age, gender, arm dominance, frequency of dislocation, age at first dislocation, timing from first dislocation, number of dislocations, cause of first dislocation, generalized ligamentous laxity, type of sport, and manual work.
Glenoid bone defect was observed in 72% of the cases. Presence of the defect was significantly associated with recurrence of dislocation compared with a single episode of dislocation, increasing number of dislocations, male gender, and type of sport. Size of the defect was significantly associated with recurrent dislocation, increasing number of dislocations, timing from first dislocation, and manual work. Presence of a critical defect was significantly associated with number of dislocations and age at first dislocation. Bony Bankart lesion was significantly associated with male gender and age at first dislocation.
The number of dislocations and age at first dislocation are the most significant predictors of glenoid bone loss in anterior shoulder instability.
肩盂骨缺损常与前肩不稳定有关，被认为是肩稳定术后不稳定复发的主要原因之一。
一些危险因素与肩盂骨缺损的存在、大小和类型显著相关。
队列研究（预后）；证据水平，2。
161 例前肩不稳定患者接受了计算机断层扫描扫描对肩盂进行形态评估，以评估肩盂骨缺损的存在、大小和类型（侵蚀或骨 Bankart 病变）。下肩盂面积丢失超过 20%被认为是“临界”骨缺损（有复发风险）。结果与以下预测因素相关：年龄、性别、手臂优势、脱位频率、首次脱位年龄、首次脱位时间、脱位次数、首次脱位原因、广泛性韧带松弛、运动类型和体力劳动。
72%的病例观察到肩盂骨缺损。与单次脱位相比，存在骨缺损与脱位复发显著相关，脱位次数增加、性别为男性和运动类型为运动。缺损的大小与复发性脱位、脱位次数增加、首次脱位时间和体力劳动显著相关。临界缺损的存在与脱位次数和首次脱位年龄显著相关。骨 Bankart 病变与男性性别和首次脱位年龄显著相关。
脱位次数和首次脱位年龄是前肩不稳定肩盂骨丢失的最重要预测因素。
