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Does bone loss accompany soft tissue based posterior shoulder instability? A retrospective MRI study
ESSKA Academy. Orhan Ö. Nov 8, 2019; 284430; epESMA-17 Topic: Shoulder
Özlem Orhan
Özlem Orhan
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Does bone loss accompany soft tissue based posterior shoulder instability? A retrospective MRI study

ePoster - epESMA-17

Topic: Sports Trauma

Orhan Ö.1, Kanatlı U.1, Sezgin E.A.1, Ataoğlu M.B.1, Özer M.2
1Medical Faculty of Gazi University, Orthopedics and Traumatology, Ankara, Turkey, 2Medical Faculty of Necmettin Erbakan University, Orthopedics and Traumatology, Konya, Turkey

Introduction: Posterior shoulder instability(PSI) is uncommon but the incidence is increasing with rising athletic participation and advancements in imaging and arthroscopic techniques. However, challenge remains in diagnosis and treatment despite these advancements.
Objective: Bone loss due to soft tissue based PSI (STPI), PSI and anteroposterior shoulder instability, was measured retrospectively using magnetic resonance imaging (MRI) records of patients operated in our clinic.
Aim: This study aims to evaluate the association between STPI and bone loss using MRI.
Methods: Records from patients (physical examination, video record of surgery and preoperative MRI images) operated for posterior and anteroposterior soft tissue based shoulder instability (n=40 and n=36, respectively) were used to retrospectively analyze patient demographics, type of instability, presence of intra-articular pathology and type of pathology, number of dislocations and measurements on sagittal and axial plane MRI images on T1 weighted fat suppressed sequences (glenoid diameter and glenoid bone defect; length, angle and arc length of Hill-Sachs (HSL) and reverse Hill-Sachs lesions (rHSL); area and diameter of humeral head).
Results: In patients with anteroposterior instability, the amount of anterior glenoid defect, rHSL length, angle, and bow length, and the ratio of the anterior glenoid defect to glenoid diameter were significantly higher(p< 0,05). There were no significant association between the presence of intra-articular pathology, glenoid diameter, posterior glenoid defect, HSL length, angle, and arc length, and the ratio of the posterior glenoid defect to glenoid diameter in patients with PSI and anteroposterior intability (p>0,05). Addition of SLAP lesions to STPIs was not associated with bone defect size (p>0,05). Increased number of dislocations was associated with increased anterior and total glenoid bone defect size, rHSL length and rHSL arc length, ratio of the glenoid anterior defect to glenoid diameter and ratio of total defect size to glenoid diameter.
Conclusion: This study showed that patients with STPI had larger bone defects, which however were not associated with instability. These patients could be adequately treated with an anatomic repair.
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