Yaka Haluk, Adem Ali, Sarikaya Baran, Özer Mustafa, Kanatli Ulunay
Department of Orthopedics and Traumatology, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye.
Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara, Türkiye.
Clin Shoulder Elb. 2025 Jun;28(2):156-162. doi: 10.5397/cise.2025.00073. Epub 2025 May 29.
This study investigated whether the coracoid apex position relative to the glenoid is associated with anterior shoulder instability (ASI). We hypothesized that the coracoid apex is positioned superiorly and medially in patients with ASI.
This study included 72 patients who underwent surgery for ASI and 72 age- and sex-matched controls. The sagittal central glenoid- coracoid angle (scGCA) and axial central glenoid-coracoid angle (acGCA), which assess the coracoid apex position relative to the glenoid center, the glenoid version (GV), and glenoid inclination (GI) were evaluated using magnetic resonance imaging. The critical shoulder angle (CSA) was measured using true anterior-posterior radiographs.
The ASI group had significantly lower scGCA and GV values than the control group (scGCA: 32.0°±4.3° vs. 39.2°±7°, P=0.004; GV: 2.2°±5.4° vs. 6.4°±5.4°, P=0.033, respectively). There was no significant difference in acGCA, GI, and CSA between the groups (P=0.377, P=0.524, P=0.847, respectively). Logistic regression analysis conducted with the scGCA, acGCA, GV, GI, and CSA parameters revealed a significant association only for scGCA (P=0.039, odds ratio: 1.28).
Lower scGCA values, which indicate a more superior position of the coracoid apex relative to the glenoid center, are associated with ASI independently of other parameters. scGCA values below 34.5°, indicating a superiorly positioned coracoid apex, showed an 85.7% sensitivity and 73.3% specificity for ASI. Level of evidence: III.
本研究调查了喙突尖相对于关节盂的位置是否与肩关节前向不稳（ASI）相关。我们假设在ASI患者中，喙突尖位于上方和内侧。
本研究纳入了72例行ASI手术的患者以及72例年龄和性别匹配的对照。使用磁共振成像评估矢状面中央关节盂-喙突角（scGCA）和轴向中央关节盂-喙突角（acGCA），这两个角度用于评估喙突尖相对于关节盂中心的位置、关节盂版本（GV）和关节盂倾斜度（GI）。使用标准前后位X线片测量临界肩角（CSA）。
ASI组的scGCA和GV值显著低于对照组（scGCA：32.0°±4.3° 对比 39.2°±7°，P = 0.004；GV：2.2°±5.4° 对比 6.4°±5.4°，P = 0.033）。两组之间的acGCA、GI和CSA无显著差异（分别为P = 0.377、P = 0.524、P = 0.847）。对scGCA、acGCA、GV、GI和CSA参数进行逻辑回归分析，结果显示仅scGCA存在显著相关性（P = 0.039，比值比：1.28）。
较低的scGCA值表明喙突尖相对于关节盂中心的位置更高，独立于其他参数，其与ASI相关。scGCA值低于34.5°表明喙突尖位置较高，对ASI的敏感性为85.7%，特异性为73.3%。证据等级：III。
