Does native glenoid anatomy predispose to shoulder instability? An MRI analysis
It is unclear if native glenohumeral anatomic features predispose young patients to instability and if such anatomic risk factors differ between males and females. The purpose of this study was to compare glenoid and humeral head dimensions between patients with a documented instability event withou...
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| Veröffentlicht in: | Journal of shoulder and elbow surgery 2022-06, Vol.31 (6), p.S110-S116 |
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| creator | Cohn, Matthew R. DeFroda, Steven F. Huddleston, Hailey P. Williams, Brady T. Singh, Harsh Vadhera, Amar Garrigues, Grant E. Nicholson, Gregory P. Yanke, Adam B. Verma, Nikhil N. |
| description | It is unclear if native glenohumeral anatomic features predispose young patients to instability and if such anatomic risk factors differ between males and females. The purpose of this study was to compare glenoid and humeral head dimensions between patients with a documented instability event without bone loss to matched controls and to evaluate for sex-based differences across measurements. The authors hypothesized that a smaller glenoid width and glenoid surface area would be significant risk factors for instability, whereas humeral head width would not.
A prospectively maintained database was queried for patients aged |
| doi_str_mv | 10.1016/j.jse.2022.03.002 |
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A prospectively maintained database was queried for patients aged <21 years who underwent magnetic resonance imaging (MRI) for shoulder instability. Patients with prior shoulder surgery, bony Bankart, or glenoid or humeral bone loss were excluded. Patients were matched by sex and age to control patients who had no history of shoulder instability. Two blinded independent raters measured glenoid height, glenoid width, and humeral head width on sagittal MRI. Glenoid surface area, glenoid index (ratio of glenoid height to width), and glenohumeral mismatch ratio (ratio of humeral head width to glenoid width) were calculated.
A total of 107 instability patients and 107 controls were included (150 males and 64 females). Among the entire cohort, there were no differences in glenoid height, glenoid width, glenoid surface area, humeral head width, or glenoid index between patients with instability and controls. Overall, those with instability had a greater glenohumeral mismatch ratio (P = .029) compared with controls. When stratified by sex, female controls and instability patients showed no differences in any of the glenoid or humerus dimensions. However, males with instability had a smaller glenoid width by 3.5% (P = .017), smaller glenoid surface area by 5.2% (P = .015), and a greater glenohumeral mismatch ratio (P = .027) compared with controls.
Compared with controls, males with instability were found to have smaller glenoid width and surface area, and a glenoid width that was proportionally smaller relative to humeral width. In contrast, bony glenohumeral morphology did not appear to be a significant risk factor for instability among females. These sex-based differences suggest that anatomic factors may influence risk of instability for male and female patients differently.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2022.03.002</identifier><identifier>PMID: 35378313</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Female ; Glenoid Cavity - surgery ; glenoid morphology ; Humans ; Humeral Head - surgery ; humeral morphology ; Joint Instability - etiology ; Magnetic Resonance Imaging ; Male ; Shoulder - pathology ; shoulder dislocation ; Shoulder Dislocation - surgery ; Shoulder instability ; Shoulder Joint - surgery</subject><ispartof>Journal of shoulder and elbow surgery, 2022-06, Vol.31 (6), p.S110-S116</ispartof><rights>2022 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-7c255a0476bade20de85b8c141c6c994d57666167a72293071bfcb78765a34dc3</citedby><cites>FETCH-LOGICAL-c326t-7c255a0476bade20de85b8c141c6c994d57666167a72293071bfcb78765a34dc3</cites><orcidid>0000-0002-2647-0524 ; 0000-0001-7755-4106 ; 0000-0002-8662-3131 ; 0000-0002-3975-1958 ; 0000-0002-9601-4217 ; 0000-0001-8518-5371 ; 0000-0001-6304-1916</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1058274622003378$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35378313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cohn, Matthew R.</creatorcontrib><creatorcontrib>DeFroda, Steven F.</creatorcontrib><creatorcontrib>Huddleston, Hailey P.</creatorcontrib><creatorcontrib>Williams, Brady T.</creatorcontrib><creatorcontrib>Singh, Harsh</creatorcontrib><creatorcontrib>Vadhera, Amar</creatorcontrib><creatorcontrib>Garrigues, Grant E.</creatorcontrib><creatorcontrib>Nicholson, Gregory P.</creatorcontrib><creatorcontrib>Yanke, Adam B.</creatorcontrib><creatorcontrib>Verma, Nikhil N.</creatorcontrib><title>Does native glenoid anatomy predispose to shoulder instability? An MRI analysis</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>It is unclear if native glenohumeral anatomic features predispose young patients to instability and if such anatomic risk factors differ between males and females. The purpose of this study was to compare glenoid and humeral head dimensions between patients with a documented instability event without bone loss to matched controls and to evaluate for sex-based differences across measurements. The authors hypothesized that a smaller glenoid width and glenoid surface area would be significant risk factors for instability, whereas humeral head width would not.
A prospectively maintained database was queried for patients aged <21 years who underwent magnetic resonance imaging (MRI) for shoulder instability. Patients with prior shoulder surgery, bony Bankart, or glenoid or humeral bone loss were excluded. Patients were matched by sex and age to control patients who had no history of shoulder instability. Two blinded independent raters measured glenoid height, glenoid width, and humeral head width on sagittal MRI. Glenoid surface area, glenoid index (ratio of glenoid height to width), and glenohumeral mismatch ratio (ratio of humeral head width to glenoid width) were calculated.
A total of 107 instability patients and 107 controls were included (150 males and 64 females). Among the entire cohort, there were no differences in glenoid height, glenoid width, glenoid surface area, humeral head width, or glenoid index between patients with instability and controls. Overall, those with instability had a greater glenohumeral mismatch ratio (P = .029) compared with controls. When stratified by sex, female controls and instability patients showed no differences in any of the glenoid or humerus dimensions. However, males with instability had a smaller glenoid width by 3.5% (P = .017), smaller glenoid surface area by 5.2% (P = .015), and a greater glenohumeral mismatch ratio (P = .027) compared with controls.
Compared with controls, males with instability were found to have smaller glenoid width and surface area, and a glenoid width that was proportionally smaller relative to humeral width. In contrast, bony glenohumeral morphology did not appear to be a significant risk factor for instability among females. These sex-based differences suggest that anatomic factors may influence risk of instability for male and female patients differently.</description><subject>Female</subject><subject>Glenoid Cavity - surgery</subject><subject>glenoid morphology</subject><subject>Humans</subject><subject>Humeral Head - surgery</subject><subject>humeral morphology</subject><subject>Joint Instability - etiology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Shoulder - pathology</subject><subject>shoulder dislocation</subject><subject>Shoulder Dislocation - surgery</subject><subject>Shoulder instability</subject><subject>Shoulder Joint - surgery</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1rGzEQhkVoaT7aH5BL0LGX3Y6klbQmhxLy1UBKoLRnoZXGrcx65WjWAf_7yjjpsaeZged9YR7GzgW0AoT5smpXhK0EKVtQLYA8YidCK9kYDfCu7qD7RtrOHLNTohUALDqQH9ix0sr2SqgT9nSTkfjk5_SC_PeIU06R-3rn9Y5vCsZEm0zI58zpT96OEQtPE81-SGOad1_51cS__3jYR8YdJfrI3i_9SPjpdZ6xX3e3P6-_NY9P9w_XV49NUNLMjQ1Saw-dNYOPKCFir4c-iE4EExaLLmprjBHGeivlQoEVwzIMtrdGe9XFoM7Y50PvpuTnLdLs1okCjqOfMG_JSdNZKRTIrqLigIaSiQou3aaktS87J8DtPbqVqx7d3qMD5arHmrl4rd8Oa4z_Em_iKnB5ALA--ZKwOAoJp1CFFQyzizn9p_4vhcuCVw</recordid><startdate>202206</startdate><enddate>202206</enddate><creator>Cohn, Matthew R.</creator><creator>DeFroda, Steven F.</creator><creator>Huddleston, Hailey P.</creator><creator>Williams, Brady T.</creator><creator>Singh, Harsh</creator><creator>Vadhera, Amar</creator><creator>Garrigues, Grant E.</creator><creator>Nicholson, Gregory P.</creator><creator>Yanke, Adam B.</creator><creator>Verma, Nikhil N.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2647-0524</orcidid><orcidid>https://orcid.org/0000-0001-7755-4106</orcidid><orcidid>https://orcid.org/0000-0002-8662-3131</orcidid><orcidid>https://orcid.org/0000-0002-3975-1958</orcidid><orcidid>https://orcid.org/0000-0002-9601-4217</orcidid><orcidid>https://orcid.org/0000-0001-8518-5371</orcidid><orcidid>https://orcid.org/0000-0001-6304-1916</orcidid></search><sort><creationdate>202206</creationdate><title>Does native glenoid anatomy predispose to shoulder instability? An MRI analysis</title><author>Cohn, Matthew R. ; DeFroda, Steven F. ; Huddleston, Hailey P. ; Williams, Brady T. ; Singh, Harsh ; Vadhera, Amar ; Garrigues, Grant E. ; Nicholson, Gregory P. ; Yanke, Adam B. ; Verma, Nikhil N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-7c255a0476bade20de85b8c141c6c994d57666167a72293071bfcb78765a34dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Female</topic><topic>Glenoid Cavity - surgery</topic><topic>glenoid morphology</topic><topic>Humans</topic><topic>Humeral Head - surgery</topic><topic>humeral morphology</topic><topic>Joint Instability - etiology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Shoulder - pathology</topic><topic>shoulder dislocation</topic><topic>Shoulder Dislocation - surgery</topic><topic>Shoulder instability</topic><topic>Shoulder Joint - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cohn, Matthew R.</creatorcontrib><creatorcontrib>DeFroda, Steven F.</creatorcontrib><creatorcontrib>Huddleston, Hailey P.</creatorcontrib><creatorcontrib>Williams, Brady T.</creatorcontrib><creatorcontrib>Singh, Harsh</creatorcontrib><creatorcontrib>Vadhera, Amar</creatorcontrib><creatorcontrib>Garrigues, Grant E.</creatorcontrib><creatorcontrib>Nicholson, Gregory P.</creatorcontrib><creatorcontrib>Yanke, Adam B.</creatorcontrib><creatorcontrib>Verma, Nikhil N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cohn, Matthew R.</au><au>DeFroda, Steven F.</au><au>Huddleston, Hailey P.</au><au>Williams, Brady T.</au><au>Singh, Harsh</au><au>Vadhera, Amar</au><au>Garrigues, Grant E.</au><au>Nicholson, Gregory P.</au><au>Yanke, Adam B.</au><au>Verma, Nikhil N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does native glenoid anatomy predispose to shoulder instability? An MRI analysis</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2022-06</date><risdate>2022</risdate><volume>31</volume><issue>6</issue><spage>S110</spage><epage>S116</epage><pages>S110-S116</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>It is unclear if native glenohumeral anatomic features predispose young patients to instability and if such anatomic risk factors differ between males and females. The purpose of this study was to compare glenoid and humeral head dimensions between patients with a documented instability event without bone loss to matched controls and to evaluate for sex-based differences across measurements. The authors hypothesized that a smaller glenoid width and glenoid surface area would be significant risk factors for instability, whereas humeral head width would not.
A prospectively maintained database was queried for patients aged <21 years who underwent magnetic resonance imaging (MRI) for shoulder instability. Patients with prior shoulder surgery, bony Bankart, or glenoid or humeral bone loss were excluded. Patients were matched by sex and age to control patients who had no history of shoulder instability. Two blinded independent raters measured glenoid height, glenoid width, and humeral head width on sagittal MRI. Glenoid surface area, glenoid index (ratio of glenoid height to width), and glenohumeral mismatch ratio (ratio of humeral head width to glenoid width) were calculated.
A total of 107 instability patients and 107 controls were included (150 males and 64 females). Among the entire cohort, there were no differences in glenoid height, glenoid width, glenoid surface area, humeral head width, or glenoid index between patients with instability and controls. Overall, those with instability had a greater glenohumeral mismatch ratio (P = .029) compared with controls. When stratified by sex, female controls and instability patients showed no differences in any of the glenoid or humerus dimensions. However, males with instability had a smaller glenoid width by 3.5% (P = .017), smaller glenoid surface area by 5.2% (P = .015), and a greater glenohumeral mismatch ratio (P = .027) compared with controls.
Compared with controls, males with instability were found to have smaller glenoid width and surface area, and a glenoid width that was proportionally smaller relative to humeral width. In contrast, bony glenohumeral morphology did not appear to be a significant risk factor for instability among females. These sex-based differences suggest that anatomic factors may influence risk of instability for male and female patients differently.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35378313</pmid><doi>10.1016/j.jse.2022.03.002</doi><orcidid>https://orcid.org/0000-0002-2647-0524</orcidid><orcidid>https://orcid.org/0000-0001-7755-4106</orcidid><orcidid>https://orcid.org/0000-0002-8662-3131</orcidid><orcidid>https://orcid.org/0000-0002-3975-1958</orcidid><orcidid>https://orcid.org/0000-0002-9601-4217</orcidid><orcidid>https://orcid.org/0000-0001-8518-5371</orcidid><orcidid>https://orcid.org/0000-0001-6304-1916</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of shoulder and elbow surgery, 2022-06, Vol.31 (6), p.S110-S116 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Female Glenoid Cavity - surgery glenoid morphology Humans Humeral Head - surgery humeral morphology Joint Instability - etiology Magnetic Resonance Imaging Male Shoulder - pathology shoulder dislocation Shoulder Dislocation - surgery Shoulder instability Shoulder Joint - surgery |
| title | Does native glenoid anatomy predispose to shoulder instability? An MRI analysis |
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