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Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability

BACKGROUND: Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been...

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Autores principales: Matsumura, Noboru, Kaneda, Kazuya, Oki, Satoshi, Kimura, Hiroo, Suzuki, Taku, Iwamoto, Takuji, Matsumoto, Morio, Nakamura, Masaya, Nagura, Takeo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045245/
https://www.ncbi.nlm.nih.gov/pubmed/33849594
http://dx.doi.org/10.1186/s13018-021-02395-5
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author Matsumura, Noboru
Kaneda, Kazuya
Oki, Satoshi
Kimura, Hiroo
Suzuki, Taku
Iwamoto, Takuji
Matsumoto, Morio
Nakamura, Masaya
Nagura, Takeo
author_facet Matsumura, Noboru
Kaneda, Kazuya
Oki, Satoshi
Kimura, Hiroo
Suzuki, Taku
Iwamoto, Takuji
Matsumoto, Morio
Nakamura, Masaya
Nagura, Takeo
author_sort Matsumura, Noboru
collection PubMed
description BACKGROUND: Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. METHODS: A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. RESULTS: Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). CONCLUSIONS: Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations.
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spelling pubmed-80452452021-04-14 Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability Matsumura, Noboru Kaneda, Kazuya Oki, Satoshi Kimura, Hiroo Suzuki, Taku Iwamoto, Takuji Matsumoto, Morio Nakamura, Masaya Nagura, Takeo J Orthop Surg Res Research Article BACKGROUND: Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. METHODS: A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. RESULTS: Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). CONCLUSIONS: Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations. BioMed Central 2021-04-13 /pmc/articles/PMC8045245/ /pubmed/33849594 http://dx.doi.org/10.1186/s13018-021-02395-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Matsumura, Noboru
Kaneda, Kazuya
Oki, Satoshi
Kimura, Hiroo
Suzuki, Taku
Iwamoto, Takuji
Matsumoto, Morio
Nakamura, Masaya
Nagura, Takeo
Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_full Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_fullStr Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_full_unstemmed Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_short Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_sort factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045245/
https://www.ncbi.nlm.nih.gov/pubmed/33849594
http://dx.doi.org/10.1186/s13018-021-02395-5
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