Background: While scapular morphology contributes to glenohumeral osteoarthritis and rotator cuff disease, its role in traumatic glenohumeral instability remains unknown. We hypothesized that coracoacromial and glenoid morphology would differ between healthy subjects and those with recurrent traumatic anterior shoulder instability.Methods: Computed tomographic scans of 31 cadaveric control scapulae and 54 scapulae of patients with recurrent traumatic anterior shoulder instability and Hill-Sachs lesions were threedimensionally reconstructed. Statistical shape modelling identified the modes of variation between the scapulae of both groups. Corresponding measurements quantified these modes in relation to the glenoid center (linear offset measures), defined by the best-fit circle of the inferior glenoid, or glenoid center plane (angles), which bisects the glenoid longitudinally. Distances were normalized for glenoid size.
Results:As compared to controls, the unstable coracoids were shorter (p=0.004), with a more superior and medial offset of the tip (mean difference [MD]: 7 and 3 mm, respectively; p<0.001), and an origin closer to the 12 o'clock position (MD: 6°; p<0.001). The unstable scapular spines