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Glenoid retroversion is an important factor for humeral head centration and the biomechanics of posterior shoulder stability.
Imhoff, Florian B; Camenzind, Roland S; Obopilwe, Elifho; Cote, Mark P; Mehl, Julian; Beitzel, Knut; Imhoff, Andreas B; Mazzocca, Augustus D; Arciero, Robert A; Dyrna, Felix G E.
Afiliación
  • Imhoff FB; Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.
  • Camenzind RS; Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.
  • Obopilwe E; Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.
  • Cote MP; Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.
  • Mehl J; Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany.
  • Beitzel K; Department of Shoulder Surgery, ATOS Clinic, Cologne, Germany.
  • Imhoff AB; Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany.
  • Mazzocca AD; Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.
  • Arciero RA; Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.
  • Dyrna FGE; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany. felix.dyrna@icloud.com.
Knee Surg Sports Traumatol Arthrosc ; 27(12): 3952-3961, 2019 Dec.
Article en En | MEDLINE | ID: mdl-31254026
ABSTRACT

PURPOSE:

Glenoid retroversion is a known independent risk factor for recurrent posterior instability. The purpose was to investigate progressive angles of glenoid retroversion and their influence on humeral head centration and posterior translation with intact, detached, and repaired posterior labrum in a cadaveric human shoulder model.

METHODS:

A total of 10 fresh-frozen human cadaveric shoulders were investigated for this study. After CT- canning, the glenoids were aligned parallel to the floor, with the capsule intact, and the humerus was fixed in 60° of abduction and neutral rotation. Version of the glenoid was created after wedge resection from posterior and fixed with an external fixator throughout the testing. Specimens underwent three conditions intact, detached, and repaired posterior labrum, while version of the glenoid was set from + 5° anteversion to - 25° retroversion by 5° increments. Within the biomechanical setup, the glenohumeral joint was axially loaded (22 N) to center the joint. At 0° of glenoid version and intact labrum, the initial position was used as baseline and served as point zero of centerization. After cyclic preloading, posterior translation force (20 N) was then applied by a material testing machine, while start and endpoints of the scapula placed on an X-Y table were measured.

RESULTS:

The decentralization of the humeral head at glenoid version angles of 5°, 10°, 15°, and 20° of retroversion and 5° of anteversion was significantly different (P < 0.001). Every increment of 5° of retroversion led to an additional decentralization of the humeral head overall by (average ± SD) 2.0 mm ± 0.3 in the intact and 2.0 mm ± 0.7 in the detached labrum condition. The repaired showed significantly lower posterior translation compared to the intact condition at 10° (P = 0.012) and 15° (P < 0.01) of retroversion. In addition, CT measured parameters (depth, diameter, and native version) of the glenoid showed no correlation with angle of dislocation of each specimen.

CONCLUSION:

Bony alignment in terms of glenoid retroversion angle plays an important role in joint centration and posterior translation, especially in retroversion angles greater than 10°. Isolated posterior labrum repair has a significant effect on posterior translation in glenoid retroversion angles of 5° and 10°. Bony correction of glenoid version may be considered to address posterior shoulder instability with retroversion > 15°.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Articulación del Hombro / Cabeza Humeral / Retroversión Ósea / Inestabilidad de la Articulación Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Articulación del Hombro / Cabeza Humeral / Retroversión Ósea / Inestabilidad de la Articulación Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Suiza