Aier Sashitemjen, Reddy Bishak, Pandey Vivek
Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India.
J Orthop. 2023 Dec 18;49:134-139. doi: 10.1016/j.jor.2023.12.012. eCollection 2024 Mar.
Posterior shoulder instability and consequent labral tear have been predominantly associated with retroversion of the bony glenoid and chondrolabral version. However, literature concerning the degree of glenoid and chondrolabral version and clinical outcomes following labral repair is scarce.
A retrospective cohort study was undertaken among patients with posterior shoulder instability who had undergone arthroscopic isolated posterior labral repair. The MRI was used to assess the bony and labral variations of the glenoid using the Friedman method and further categorized as either anteverted or retroverted glenoid. American Shoulder and Elbow Surgeons (ASES), Oxford Shoulder Score (OSS), and Single Assessment Numeric Evaluation (SANE) scores were used to evaluate pre- and postoperative clinical outcomes at a minimum follow-up of one year.
33 shoulder MRIs performed at our institution were available for radiographic analysis. Among the 33 shoulders that underwent posterior shoulder capsulolabral repair, 23 were available for clinical follow-up for at least one year (range, 12-108 months). The mean (±SD) labral version and bony version were -3.98 (±5.68) and -2.83 (±5.20), respectively. The mean (±SD) postoperative ASES, Oxford score, and SANE scores for all participants were 84.04 (±14.14), 43.38 (±3.81), and 78.57 (±17.40), respectively. However, the difference in clinical outcomes in patients with anteverted or retroverted glenoid versions was not statistically significant.
Our study concludes a strong correlation between posterior glenohumeral instability and higher degree of glenoid retroversion. Nevertheless, variations in the glenoid version appear to have no significant impact on clinical outcomes.
Level IV, retrospective cohort.
肩关节后向不稳及随之而来的盂唇撕裂主要与肩胛盂骨的后倾及软骨盂唇后倾有关。然而,关于肩胛盂及软骨盂唇后倾程度以及盂唇修复后的临床结果的文献较少。
对接受关节镜下单纯后盂唇修复的肩关节后向不稳患者进行回顾性队列研究。使用弗里德曼方法通过磁共振成像(MRI)评估肩胛盂的骨和盂唇变异,并进一步分类为前倾或后倾肩胛盂。采用美国肩肘外科医师学会(ASES)评分、牛津肩关节评分(OSS)和单评估数字评价(SANE)评分,在至少一年的最短随访期评估术前和术后的临床结果。
本机构进行的33例肩部MRI可用于影像学分析。在接受后肩关节囊盂唇修复的33例肩部中,23例可进行至少一年(范围为12 - 108个月)的临床随访。盂唇平均(±标准差)后倾角度和骨后倾角度分别为-3.98(±5.68)和-2.83(±5.20)。所有参与者术后ASES、牛津评分和SANE评分的平均值(±标准差)分别为84.04(±14.14)、43.38(±3.81)和78.57(±17.40)。然而,肩胛盂前倾或后倾患者的临床结果差异无统计学意义。
我们的研究得出结论,肩肱关节后向不稳与肩胛盂较高程度的后倾之间存在密切相关性。尽管如此,肩胛盂后倾角度的变化似乎对临床结果没有显著影响。
IV级,回顾性队列研究。