Willigenburg N W, Bouma R A, Scholtes Vab, van der Hulst Vpm, van Deurzen Dfp, van den Bekerom Mpj
JointResearch, Department of Orthopaedic Surgery, OLVG Amsterdam, the Netherlands.
Department of Radiology, OLVG Amsterdam, the Netherlands.
Shoulder Elbow. 2019 Dec;11(6):424-429. doi: 10.1177/1758573218805099. Epub 2018 Oct 23.
Bony lesions after shoulder dislocation reduce the joint contact area and increase the risk of recurrent instability. It is unknown whether the innate relative sizes of the humeral head and glenoid may predispose patients to shoulder instability. This study evaluated whether anterior shoulder instability is associated with a larger innate humeral head/glenoid ratio (IHGR).
We evaluated CT scans of 40 shoulders with anterior shoulder instability and 48 controls. We measured axial humeral head diameter and glenoid diameter following native contours, discarding any bony lesions, and calculated IHGR by dividing both diameters. Multivariate logistic regression determined whether the IHGR, corrected for age and gender as potential confounders, was associated with anterior shoulder instability.
Mean IHGR was 1.48 ± 0.23 in the group with anterior shoulder instability and 1.42 ± 0.20 in the group without anterior shoulder instability. Measurements for axial humeral head and axial glenoid diameters demonstrated excellent intra-rater reliability (ICC range: 0.94-0.95). IHGR was not significantly associated with anterior shoulder instability (OR = 1.105, 95%CI = 0.118-10.339, p = 0.930).
The innate ratio of humeral head and glenoid diameters was not significantly associated with anterior shoulder instability in this retrospective sample of 88 shoulder CT scans.
肩关节脱位后的骨损伤会减少关节接触面积，并增加复发性不稳定的风险。尚不清楚肱骨头和关节盂的固有相对大小是否会使患者易患肩关节不稳定。本研究评估了前肩关节不稳定是否与较大的固有肱骨头/关节盂比率（IHGR）相关。
我们评估了40例前肩关节不稳定患者和48例对照者的CT扫描结果。我们沿着自然轮廓测量肱骨头轴向直径和关节盂直径，排除任何骨损伤，并通过将两个直径相除来计算IHGR。多因素逻辑回归分析确定在校正年龄和性别作为潜在混杂因素后，IHGR是否与前肩关节不稳定相关。
前肩关节不稳定组的平均IHGR为1.48±0.23，无前肩关节不稳定组为1.42±0.20。肱骨头轴向直径和关节盂轴向直径的测量显示出极好的评分者内信度（ICC范围：0.94 - 0.95）。IHGR与前肩关节不稳定无显著相关性（OR = 1.105，95%CI = 0.118 - 10.339，p = 0.930）。
在这个包含88例肩部CT扫描的回顾性样本中，肱骨头和关节盂直径的固有比率与前肩关节不稳定无显著相关性。
