Enlargement of Glenoid Defects in Traumatic Anterior Shoulder Instability: Influence of the Number of Recurrences and Type of Sport.
Enlargement of Glenoid Defects in Traumatic Anterior Shoulder Instability: Influence of the Number of Recurrences and Type of Sport.
复制标题
创伤性前肩不稳定性中关节盂缺陷的扩大：复发次数和运动类型的影响。
DOI：
10.1177/2325967114529920
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发表时间：
2014-04
影响因子：
2.6
通讯作者：
Mae T
中科院分区：
文献类型：
--
作者：
Nakagawa S;Ozaki R;Take Y;Mizuno N;Mae T
创伤性肩关节前不稳定患者的大关节盂边缘缺损通常被认为是关节镜下Bankart修复的禁忌症，20%至27%的缺损被认为是临界尺寸。虽然据报道脱位复发、男性性别和碰撞运动是影响大关节盂缺陷的重要因素，但尚未研究半脱位和更详细运动类型的影响。详细研究关节脱位和半脱位的数量以及运动类型对关节盂缺损的发生和大小的影响。病例对照研究;证据等级，3。共223个肩关节（60个原发性不稳定，163个复发性不稳定）进行了前瞻性计算机断层扫描检查。比较原发性和复发性不稳定的关节盂边缘形态。在复发性不稳定的患者中，研究了关节盂缺损与脱位和半脱位数量之间的关系。此外，还比较了49名男性美式橄榄球运动员、41名男性橄榄球运动员、27名男性棒球运动员和25名女性运动员的关节盂缺陷。肩盂缺损的平均程度在原发性不稳定的肩关节中为3.5%，在复发性不稳定的肩关节中为11.3%。在108例复发性不稳定肩关节（66.2%）和12例原发性不稳定肩关节（20%）中检测到关节盂缺损。关于脱位/半脱位总数的影响，在85个肩关节中，肩盂缺损的平均程度为6.3%，发生2 - 5起事件，34个肩关节中为12.9%，发生6 - 10起事件，44个肩关节中为19.6%，发生11起或更多事件。随着复发次数的增加，关节盂缺损明显沿着增大。虽然没有脱位的复发性半脱位也影响关节盂缺损的大小，但脱位的数量没有影响。橄榄球运动员肩盂缺损的平均程度为12.0%，美式足球运动员为8.9%，女运动员为4.7%，棒球运动员为4.5%。男性棒球运动员和女性运动员的关节盂缺损明显小于男性碰撞运动员。由于复发性脱位和半脱位造成的损伤，关节盂缺损明显扩大;因此，原发性和复发性不稳定之间的关节盂边缘形态有明显差异。关节盂缺损的大小也受性别和运动类型的影响。
Large glenoid rim defects in patients with traumatic anterior shoulder instability are often regarded as a contraindication for arthroscopic Bankart repair, with a defect of 20% to 27% considered as the critical size. While recurrence of dislocations, male sex, and collision sports were reported to be the significant factors influencing large glenoid defects, the influences of subluxations and more detailed types of sports were not investigated. To investigate the influence of the number of dislocations and subluxations and type of sport on the occurrence and size of glenoid defects in detail. Case-control study; Level of evidence, 3. A total of 223 shoulders (60 with primary instability, 163 with recurrent instability) were prospectively examined by computed tomography. Glenoid rim morphology was compared between primary and recurrent instability. In patients with recurrent instability, the relationship between the glenoid defect and the number of dislocations and subluxations was investigated. In addition, glenoid defects were compared among 49 male American football players, 41 male rugby players, 27 male baseball players, and 25 female athletes. The mean extent of the glenoid defect was 3.5% in shoulders with primary instability and 11.3% in those with recurrent instability. A glenoid defect was detected in 108 shoulders (66.2%) with recurrent instability versus 12 shoulders (20%) with primary instability. Regarding the influence of the total number of dislocations/subluxations, the average extent of the glenoid defect was 6.3% in 85 shoulders with 2 to 5 events, 12.9% in 34 shoulders with 6 to 10 events, and 19.6% in 44 shoulders with 11 or more events. The glenoid defect became significantly larger along with an increasing number of recurrences. Although recurrent subluxation without dislocation also influenced the glenoid defect size, the number of dislocations did not. The average extent of the glenoid defect was 12.0% in rugby players, 8.9% in American football players, 4.7% in female athletes, and 4.5% in baseball players. Glenoid defects were significantly smaller in male baseball players and female athletes than in male collision athletes. The glenoid defect is significantly enlarged by damage due to recurrent dislocation and subluxation; therefore, glenoid rim morphology differs markedly between primary and recurrent instability. Glenoid defect size is also influenced by sex and by the type of sport.