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Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability
BACKGROUND: With recurrent anterior instability the bone fragment of a bony Bankart lesion is often small compared to the glenoid defect. The purpose of the present study was to clarify the changes to both the bone fragment and glenoid defect over time in a single subject. METHODS: Participants were...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998875/ https://www.ncbi.nlm.nih.gov/pubmed/36911769 http://dx.doi.org/10.1016/j.jseint.2022.12.010 |
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author | Nakagawa, Shigeto Hirose, Takehito Uchida, Ryohei Nakamura, Hiroyuki Mae, Tatsuo Hayashida, Kenji Yoneda, Minoru |
author_facet | Nakagawa, Shigeto Hirose, Takehito Uchida, Ryohei Nakamura, Hiroyuki Mae, Tatsuo Hayashida, Kenji Yoneda, Minoru |
author_sort | Nakagawa, Shigeto |
collection | PubMed |
description | BACKGROUND: With recurrent anterior instability the bone fragment of a bony Bankart lesion is often small compared to the glenoid defect. The purpose of the present study was to clarify the changes to both the bone fragment and glenoid defect over time in a single subject. METHODS: Participants were patients who underwent computed tomography (CT) at least twice after an instability event between 2004 and 2021 and had a fragment-type glenoid at first CT. The glenoid rim width (A), glenoid defect width (B), and bone fragment width (C) were measured in millimeters. If B or C increased by 1 mm or more from the first to final CT, the change was judged as “enlarged,” and if B or C decreased by 1 mm or more, it was judged as “reduced”; all other cases were judged as “similar.” Then, glenoid defect size and bone fragment size were calculated as B/A×100% and C/A×100%, respectively, and the changes from the first to final CT were compared. RESULTS: From the first to final CT, the glenoid defect was enlarged in 30 shoulders, similar in 13 shoulders, and reduced in 4 shoulders, and the bone fragment was enlarged in 18 shoulders, similar in 24 shoulders, and reduced in 5 shoulders. The mean glenoid defect size significantly increased from 10.9% to 15.3% (P < .001), and the mean bone fragment size increased from 6.4% to 7.8%, respectively (P = .005). At the final CT, in 6 shoulders a new glenoid fracture was observed at a different site from the original fracture. When they were excluded from the analyses, the mean glenoid defect size still significantly increased (from 11.2% to 15.2%; P < .001), but the mean bone fragment size did not (6.5% vs. 7.3%, respectively; P = .088). CONCLUSIONS: In shoulders with recurrent anterior instability, glenoid defect size appears to increase significantly over time, whereas the bone fragment size remains unchanged or increases only slightly. Bone fragment resorption is quite rare, and a bone fragment appears to be small because of an enlarged glenoid defect. |
format | Online Article Text |
id | pubmed-9998875 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-99988752023-03-11 Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability Nakagawa, Shigeto Hirose, Takehito Uchida, Ryohei Nakamura, Hiroyuki Mae, Tatsuo Hayashida, Kenji Yoneda, Minoru JSES Int Shoulder BACKGROUND: With recurrent anterior instability the bone fragment of a bony Bankart lesion is often small compared to the glenoid defect. The purpose of the present study was to clarify the changes to both the bone fragment and glenoid defect over time in a single subject. METHODS: Participants were patients who underwent computed tomography (CT) at least twice after an instability event between 2004 and 2021 and had a fragment-type glenoid at first CT. The glenoid rim width (A), glenoid defect width (B), and bone fragment width (C) were measured in millimeters. If B or C increased by 1 mm or more from the first to final CT, the change was judged as “enlarged,” and if B or C decreased by 1 mm or more, it was judged as “reduced”; all other cases were judged as “similar.” Then, glenoid defect size and bone fragment size were calculated as B/A×100% and C/A×100%, respectively, and the changes from the first to final CT were compared. RESULTS: From the first to final CT, the glenoid defect was enlarged in 30 shoulders, similar in 13 shoulders, and reduced in 4 shoulders, and the bone fragment was enlarged in 18 shoulders, similar in 24 shoulders, and reduced in 5 shoulders. The mean glenoid defect size significantly increased from 10.9% to 15.3% (P < .001), and the mean bone fragment size increased from 6.4% to 7.8%, respectively (P = .005). At the final CT, in 6 shoulders a new glenoid fracture was observed at a different site from the original fracture. When they were excluded from the analyses, the mean glenoid defect size still significantly increased (from 11.2% to 15.2%; P < .001), but the mean bone fragment size did not (6.5% vs. 7.3%, respectively; P = .088). CONCLUSIONS: In shoulders with recurrent anterior instability, glenoid defect size appears to increase significantly over time, whereas the bone fragment size remains unchanged or increases only slightly. Bone fragment resorption is quite rare, and a bone fragment appears to be small because of an enlarged glenoid defect. Elsevier 2022-12-21 /pmc/articles/PMC9998875/ /pubmed/36911769 http://dx.doi.org/10.1016/j.jseint.2022.12.010 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Shoulder Nakagawa, Shigeto Hirose, Takehito Uchida, Ryohei Nakamura, Hiroyuki Mae, Tatsuo Hayashida, Kenji Yoneda, Minoru Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability |
title | Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability |
title_full | Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability |
title_fullStr | Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability |
title_full_unstemmed | Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability |
title_short | Glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability |
title_sort | glenoid defect size increases but the bone fragment rarely resorbs in shoulders with recurrent anterior instability |
topic | Shoulder |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998875/ https://www.ncbi.nlm.nih.gov/pubmed/36911769 http://dx.doi.org/10.1016/j.jseint.2022.12.010 |
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