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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(04): 612-618
DOI: 10.1055/s-0041-1741022
Artigo Original
Ombro e Cotovelo

Clinical Validation of the Glenoid Track Concept in Anterior Glenohumeral Instability

Article in several languages: português | English
Mauro Emilio Conforto Gracitelli 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Frederico Lafraia Lobo 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Eduardo Angeli Malavolta 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Jorge Henrique Assunção 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Fernando Brandão de Andrade-Silva 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Arnaldo Amado Ferreira Neto 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Abstract

Objective To evaluate the correlation of the glenoid track and glenoidal bone loss with the recurrence dislocation rate and the Rowe score.

Methods Retrospective study that assessed the glenoid track and glenoidal bone loss through preoperative magnetic resonance imaging. Patients undergoing primary arthroscopic repair of anterior Bankart were included. Patients with glenoidal bone loss greater than 21%, rotator cuff tear, scapular waist fracture, and posterior or multidirectional instability were not included. Rowe score were the primary outcome, and the recurrence rate was the secondary outcome.

Results One hundred and two patients were included. Postoperative recurrent instability was reported by 8 patients (7.8%). Four patients (50%) in the group with recurrence presented glenoidal bone loss greater than 13.5% against 24 (25.5%) in the group without recurrence (p = 0.210), with a negative predictive value of 94.6%. Three patients (37.5%) in the recurrence group were considered off-track, against 13 (13.8%) in the group without recurrence (p = 0.109), with a negative predictive value of 94.2%. Patients with absolute glenoid track value ≤ 1.5 mm had worse results in relation to the recurrence group, with 6 patients (75%) presenting recurrence (p = 0.003).

Conclusion Off-track injury and glenoidal bone loss greater than the subcritical are not related to the recurrence rate and Rowe score, despite the high negative predictive value. The cut of the absolute value of the glenoid track at 1.5 mm had a significant relationship with the recurrence rate.

Keywords

Bankart lesions - glenoid cavity - shoulder dislocation

Financial support

There was no financial support from public, commercial, or non-profit sources.


Work developed in Shoulder and Elbow Surgery, Institute of Orthopedics and Traumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.




Publication History

Received: 15 April 2021

Accepted: 09 September 2021

Article published online:
15 February 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Handoll HHG, Almaiyah MA, Rangan A. Surgical versus non-surgical treatment for acute anterior shoulder dislocation. Cochrane Database Syst Rev 2004; (01) CD004325
    PubMedGoogle Scholar
  • 2 Balg F, Boileau P. The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br 2007; 89 (11) 1470-1477
    CrossrefPubMedGoogle Scholar
  • 3 Di Giacomo G, Itoi E, Burkhart SS. Evolving concept of bipolar bone loss and the Hill-Sachs lesion: from “engaging/non-engaging” lesion to “on-track/off-track” lesion. Arthroscopy 2014; 30 (01) 90-98
    CrossrefPubMedGoogle Scholar
  • 4 Phadnis J, Arnold C, Elmorsy A, Flannery M. Utility of the Instability Severity Index Score in Predicting Failure After Arthroscopic Anterior Stabilization of the Shoulder. Am J Sports Med 2015; 43 (08) 1983-1988
    CrossrefPubMedGoogle Scholar
  • 5 Ferreira Neto AA, Camanho GL, Felix AM. et al. Tratamento artroscópico da instabilidade anterior do ombro: estudo retrospectivo de 159 casos. Acta Ortop Bras 2011; 19 (01) 41-44
    CrossrefGoogle Scholar
  • 6 Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 2000; 16 (07) 677-694
    CrossrefPubMedGoogle Scholar
  • 7 Yamamoto N, Itoi E, Abe H. et al. Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track. J Shoulder Elbow Surg 2007; 16 (05) 649-656
    CrossrefPubMedGoogle Scholar
  • 8 Pécora JOR, Neves Junior AT, Roesler CRM. et al. Glenoid track evaluation by a validated finite-element shoulder numerical model. Orthop Traumatol Surg Res 2020; 106 (04) 735-742
    CrossrefPubMedGoogle Scholar
  • 9 Yamamoto N, Kawakami J, Nagamoto H, Shiota Y, Itoi E. The relationship between the glenoid track and the range of shoulder motion: A cadaver study. Orthop Traumatol Surg Res 2018; 104 (06) 793-796
    CrossrefPubMedGoogle Scholar
  • 10 Momaya AM, Tokish JM. Applying the Glenoid Track Concept in the Management of Patients with Anterior Shoulder Instability. Curr Rev Musculoskelet Med 2017; 10 (04) 463-468
    CrossrefPubMedGoogle Scholar
  • 11 Gulati A, Dessouky R, Wadhwa V, Sanders D, Chhabra A. New concepts of radiologic preoperative evaluation of anterior shoulder instability: on-track and off-track lesions. Acta Radiol 2018; 59 (08) 966-972
    CrossrefPubMedGoogle Scholar
  • 12 Ho A, Kurdziel MD, Koueiter DM, Wiater JM. Three-dimensional computed tomography measurement accuracy of varying Hill-Sachs lesion size. J Shoulder Elbow Surg 2018; 27 (02) 350-356
    CrossrefPubMedGoogle Scholar
  • 13 Burns DM, Chahal J, Shahrokhi S. et al. Diagnosis of Engaging Bipolar Bone Defects in the Shoulder Using 2-Dimensional Computed Tomography: A Cadaveric Study. Am J Sports Med 2016; 44 (11) 2771-2777
    CrossrefPubMedGoogle Scholar
  • 14 Shaha JS, Cook JB, Rowles DJ, Bottoni CR, Shaha SH, Tokish JM. Clinical Validation of the Glenoid Track Concept in Anterior Glenohumeral Instability. J Bone Joint Surg Am 2016; 98 (22) 1918-1923
    CrossrefPubMedGoogle Scholar
  • 15 Locher J, Wilken F, Beitzel K. et al. Hill-Sachs Off-track Lesions as Risk Factor for Recurrence of Instability After Arthroscopic Bankart Repair. Arthroscopy 2016; 32 (10) 1993-1999
    CrossrefPubMedGoogle Scholar
  • 16 Shaha JS, Cook JB, Song DJ. et al. Redefining “Critical” Bone Loss in Shoulder Instability: Functional Outcomes Worsen With “Subcritical” Bone Loss. Am J Sports Med 2015; 43 (07) 1719-1725
    CrossrefPubMedGoogle Scholar
  • 17 Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am 1978; 60 (01) 1-16
    CrossrefPubMedGoogle Scholar
  • 18 Assunção JH, Gracitelli ME, Borgo GD, Malavolta EA, Bordalo-Rodrigues M, Ferreira Neto AA. Tomographic evaluation of Hill-Sachs lesions: is there a correlation between different methods of measurement?. Acta Radiol 2017; 58 (01) 77-83
    CrossrefPubMedGoogle Scholar
  • 19 Miyazaki AN, Silva LA, Santos PD, Sella GDV, Nagaya LH, Checchia SL. Hill-Sachs lesion measurement with tridimensional models in anterior shoulder instability. Rev Bras Ortop 2018; 53 (03) 357-363
    Google Scholar
  • 20 Chuang TY, Adams CR, Burkhart SS. Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 2008; 24 (04) 376-382
    CrossrefPubMedGoogle Scholar
  • 21 Itoi E, Lee SB, Amrami KK, Wenger DE, An KN. Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography. Am J Sports Med 2003; 31 (01) 112-118
    CrossrefPubMedGoogle Scholar
  • 22 Godinho GG, Freitas JMA, França FdeO, de Lago E Santos FM, Aragão AA, Barros MK. Bankart arthroscopic procedure: comparative study on use of double or single-thread anchors after a 2-year follow-up. Rev Bras Ortop 2014; 50 (01) 94-99
    Google Scholar
  • 23 de Almeida Filho IA, de Castro Veado MA, Fim M, da Silva Corrêa LV, de Carvalho Junior AE. Functional assessment of arthroscopic repair for recurrent anterior shoulder instability. Rev Bras Ortop 2015; 47 (02) 214-221
    Google Scholar
  • 24 França FO, Godinho AC, Carneiro Leal DPC, Mantovani MM, Frazão RR, Mariz RF. Clinical and Image Outcomes of the Hill-Sachs Injury Approach by the Remplissage Technique on the Anterior Shoulder Instability. Rev Bras Ortop (Sao Paulo) 2019; 54 (01) 13-19
    Google Scholar
  • 25 Gracitelli MEC, Helito CP, Malavolta EA. et al. Results from filling “Remplissage” arthroscopic technique for recurrent anterior shoulder dislocation. Rev Bras Ortop 2015; 46 (06) 684-690
    Google Scholar
  • 26 Ikemoto RY, Murachovisky J, Nascimento LGP. et al. Results from latarjet Surgery for trating traumatic anterior shoulder instability associated with bone erosion in the glenoid cavity, after minium follow-up of one year. Rev Bras Ortop 2015; 46 (05) 553-560
    Google Scholar
  • 27 Ferreira AA, Malavolta EA, Gracitelli MEC. et al. Treatment of recurrent anterior shoulder disclocation with Bristow-Laterjet procedure. Acta Ortop Bras 2021; 29 (01) 39-44
    CrossrefPubMedGoogle Scholar
  • 28 da Silva LA, da Costa Lima ÁG, Kautsky RM, Santos PD, do Val Sella G, Checchia SL. Evaluation of the results and complications of the Latarjet procedure for recurrent anterior dislocation of the shoulder. Rev Bras Ortop 2015; 50 (06) 652-659
    CrossrefPubMedGoogle Scholar
  • 29 Schneider AK, Hoy GA, Ek ET. et al. Interobserver and intraobserver variability of glenoid track measurements. J Shoulder Elbow Surg 2017; 26 (04) 573-579
    CrossrefPubMedGoogle Scholar
  • 30 Bottoni CR, Johnson JD, Zhou L. et al. Arthroscopic Versus Open Anterior Shoulder Stabilization: A Prospective Randomized Clinical Trial With 15-Year Follow-up With an Assessment of the Glenoid Being “On-Track” and “Off-Track” as a Predictor of Failure. Am J Sports Med 2021; 49 (08) 1999-2005
    CrossrefPubMedGoogle Scholar