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Bony defects in chronic anterior posttraumatic dislocation of the shoulder: Is there a correlation between humeral and glenoidal lesions?

  • Original Article • SHOULDER - DISLOCATION
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

The prevalence of combined humeral and glenoid defects varies between 79 and 84 % in case of chronic posttraumatic anterior shoulder instability. The main goal of this study was to evaluate the relationship between humeral and glenoid defects based on quantitative radiological criteria.

Methods

A retrospective study was performed between 2000 and 2011 including patients who underwent primary surgical shoulder stabilization for chronic posttraumatic anterior shoulder instability, with bone defects in both the glenoid and humerus and a healthy contralateral shoulder. The following measurements were taken: D/R ratio (Hill–Sachs lesion depth/humeral head radius) on an AP X-ray in internal rotation and the D1/D2 ratio [diameter of the involved glenoid articular surfaces (D1)/the healthy one (D2)] on a comparative Bernageau glenoid profile view. Measurements were taken by two observers. Correlations were determined by the Spearman correlation coefficients (r), Bland and Altman diagrams, and intra-class correlation coefficients (ICC). A sample size calculation was done.

Results

Thirty patients were included, 25 men/5 women, mean age 29.8 ± 11.2 years. The mean D/R was 23 ± 12 % for observer 1 and 23 ± 10 % for observer 2. The mean D1/D2 was 95 ± 4 % for observer 1 and 94 ± 6 % for observer 2. No significant correlation was found between humeral and glenoid bone defects by observer 1 (r = 0.23, p = 0.22) or observer 2 (r = 0.05, p = 0.78). Agreement of the observers for the D/R ratio was excellent (ICC = 0.89 ± 0.04, p < 0.00001) and good for the D1/D2 ratio (ICC = 0.54 ± 0.14, p = 0.006).

Conclusion

Humeral and glenoid bone defects were not correlated. Inter-observer reliability was excellent for the D/R ratio and good for the D1/D2 ratio.

Level of evidence

Nonconsecutive Patients, Diagnostic Study, Level III.

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Authors and Affiliations

  1. Hôpitaux universitaires Paris Île-de-France Ouest, AP–HP, 92100, Boulogne-Billancourt, France

    Grégoire Ciais, Shahnaz Klouche, Alexandre Fournier, Benoit Rousseau, Thomas Bauer & Philippe Hardy

  2. Université de Versailles Saint-Quentin-en-Yvelines, 78035, Versailles, France

    Philippe Hardy

  3. Ambroise Paré Hospital, 9, Avenue Charles De Gaulle, 92104, Boulogne-Billancourt, France

    Grégoire Ciais

Authors
  1. Grégoire Ciais
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  2. Shahnaz Klouche
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  3. Alexandre Fournier
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  4. Benoit Rousseau
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  5. Thomas Bauer
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  6. Philippe Hardy
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Correspondence to Grégoire Ciais.

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Conflict of interest

T. Bauer is a consultant for Arthrex. P. Hardy is a consultant for Arthrex and Zimmer. The other authors (G. Ciais, S. Klouche, A. Fournier, B. Rousseau) declare that they have no conflicts of interest concerning this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments. The study was approved by the institutional review board of Comité de Protection des Personnes Ile de France VI, Hôpital La Pitié Salpêtrière, 75013 Paris, France.

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Informed consent was obtained from all individual participants included in the study.

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Ciais, G., Klouche, S., Fournier, A. et al. Bony defects in chronic anterior posttraumatic dislocation of the shoulder: Is there a correlation between humeral and glenoidal lesions?. Eur J Orthop Surg Traumatol 26, 581–586 (2016). https://doi.org/10.1007/s00590-016-1815-6

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  • DOI: https://doi.org/10.1007/s00590-016-1815-6

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