Is there a relationship between Buford complex and glenoid version?

BACKGROUND

This study aimed to investigate the relationship between the arthroscopically demonstrated Buford complex (BC) and scapular morphology in patients with anterior shoulder instability (ASI) and rotator cuff tears (RCT). We hypothesized that there may be a relationship between BC and scapular morphology.

MATERIAL AND METHODS

1947 consecutive shoulder arthroscopy cases performed between 2015 and 2023 were retrospectively evaluated. 17 BC with ASI, 25 RCT with BC, 50 with RCT control group, 50 with ASI control group, and 60 with general control group were included in the study. Critical shoulder angle (CSA) on true anterior posterior radiographs, glenoid version (GV) and glenoid inclination (GI) values on magnetic resonance imaging were compared in all groups.

RESULTS

The mean GV in the RCT with BC group was significantly lower than in the RCT control group (P < 0.001, -1º±3.3º vs 7.7º± 5.7º) and in the ASI with BC group than in the ASI control group (p < 0.001, -1.9º± 3.6º vs 3.35º± 4.8º). The mean GV in all patients with BC was significantly lower than the sum of the RCT, ASI control groups, and the general control group(P < 0.001,P < 0.001), with no difference between the groups in terms of GI and CSA.

CONCLUSION

In patients with RCT and ASI, the glenoid was more antevert in patients with the arthroscopically demonstrated BC. The BC may be a compensatory variation that develops against the tendency of the humeral head to shift anteriorly due to a reduced GV, and when the BC is diagnosed, it should be kept in mind that a more antevert glenoid may be encountered.

LEVEL OF EVIDENCE

Level III retrospective comparative study.