Detaillierte Beitrags-Information

Zurück zur Liste

Beitragstitel Does the osseous configuration of the shoulder joint predispose to shoulder instability?
Beitragscode P003
Autoren
  1. Kerstin Bütler Spital Muri Vortragender
  2. Arno Frigg Fusschirurgie Zürich
  3. Holger Grehn Kantonsspital Graubünden
Präsentationsform Poster
Themengebiete
  • A01 - Schulter/Ellbogen
Abstract Introduction: The stability of the shoulder depends on three factors: the bony morphology, the glenohumeral ligaments and the muscular balance. The influence of the osseous configuration on the shoulder stability has been controversially discussed in literature. Different measuring methods were used to measure parameters of the glenoid and the humeral head. The aim of this study was to investigate if there is a correlation between the bony configuration of the shoulder joint and shoulder instability, using a 3D-viewer and therefore being able to adjust the axis of the MR images to the measuring axis.
Methods: 31 patients with a shoulder dislocation were included and 37 patients without a shoulder dislocation. MR images were conducted of the shoulder and the elbow without moving the patient. Glenoid version, inclination of the glenoid, anterior-posterior and superior-inferior diameter of the glenoid, concavity of the glenoid, humeral torsion, anterior-posterior, medio-lateral and superior-inferior diameter of the humeral head, acromionindex as well as the index “lower” glenoid ap/Humerus ap were measured using 3D reconstruction.
Results: Among the 37 patients with a shoulder dislocation, 87.1% had an anterior shoulder dislocation. The statistical analysis of the patients with anterior instability with the control group showed a statistically significant difference in the index “lower” glenoid ap/Humerus ap. Patients with anterior instability had an index of 0.58, the control group 0.60 (p=0.04). No statistically significant difference was found concerning the diameter of the humeral head or the glenoid, the inclination of the glenoid, the concavity of the glenoid or the acromion index, neither regarding all types of instability together, nor regarding only the anterior instability
Conclusion: The static osseous stabilizers of the shoulder alone are less relevant for the shoulder stability as expected. The shoulder joint is a muscular guided and stabilized joint. Thus, divergent static glenohumeral structures can be compensated and stabilized dynamically. Only the index of the anterior-posterior glenoid diameter “lower” to the anterior-posterior diameter of the humeral head was found to be statistically different in our study. In our opinion, it is important for future studies to determine the proportion of the glenoid to the humeral head in an index, because the proportion of the glenoid to the humeral head is crucial for the static stability of the shoulder.