Influence of coracoid anatomy on the location of glenoid rim defects in anterior shoulder instability: 3D CT-scan evaluation of 51 patients

Li, Mike Mengyang; Goetti, Patrick; Sandman, Émilie; Rouleau, Dominique M.

doi:10.1007/s00276-020-02492-w

Cited by 6 publications

(6 citation statements)

References 33 publications

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“…As recently shown, the anatomy of the coracoid also has an influence on the deflection of the humeral head and the location of associated bony glenoid defects. 28 This suggests that the path of least resistance may influence the location with higher risk for traumatic fractures. Thus, an anteroinferior located GLAD lesion may cause the humeral head to displace more inferiorly, where the coracoid may provide less or no bony restraint.…”

Section: Resultsmentioning

confidence: 99%

The Glenolabral Articular Disruption Lesion Is a Biomechanical Risk Factor for Recurrent Shoulder Instability

Wermers

Schliemann

Raschke

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To investigate the biomechanical effect of a glenolabral articular disruption (GLAD) lesion on glenohumeral laxity. Methods: Human cadaveric glenoids (n ¼ 10) were excised of soft tissue, including the labrum to focus on the biomechanical effects of osteochondral surfaces. Glenohumeral dislocations were performed in a robotic test setup, while displacement forces and three-dimensional morphometric properties were measured. The stability ratio (SR), a biomechanical characteristic for glenohumeral stability, was used as an outcome parameter, as well as the path of least resistance, determined by a hybrid robot displacement. The impacts of chondral and bony defects were analyzed related to the intact glenoid. Statistical comparison of the defect states on SR and the path of least resistance was performed using repeated-measures ANOVA and Tukey's post hoc test for multiple comparisons (P < .05). The relationship between concavity depth and SR was approximated in a nonlinear regression. Results: The initial SR of the intact glenoid (28.3 AE 7.8%) decreased significantly by 4.7 AE 3% in case of a chondral defect (P ¼ .002). An additional loss of 3.2 AE 2.3% was provoked by a 20% bony defect (P ¼ .004). The path of least resistance was deflected significantly more inferiorly by a GLAD lesion (2.9 AE 1.8 , P ¼ .002) and even more by a bony defect (2.5 AE 2.9 , P ¼ .002). The nonlinear regression with concavity depth as predictor for the SR resulted in a high correlation coefficient (r ¼ .81). Conclusions: Chondral integrity is an important contributor to the SR. Chondral defects as present in GLAD lesions may cause increased laxity, influence the humeral track on the glenoid during dislocation, and represent a biomechanical risk factor for a recurrent instability.

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Section: Resultsmentioning

confidence: 99%

The Glenolabral Articular Disruption Lesion Is a Biomechanical Risk Factor for Recurrent Shoulder Instability

Wermers

Schliemann

Raschke

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Variation in coracoid shape across patients can be substantial and has been investigated for its potential use as a bone graft in procedures for AGI 1,2 . Beyond assessing post-traumatic bipolar glenohumeral bone defects, some studies have evaluated additional osseous morphological variables that can contribute to AGI 1,[3][4][5] . Owens et al established a prospective cohort of 714 subjects to investigate modifiable and nonmodifiable risk factors in the etiology of recurrent traumatic AGI.…”

Section: Anatomical Rationalementioning

confidence: 99%

The Trillat Procedure for Anterior Glenohumeral Instability

Garcia

Chaney

Martini³

et al. 2022

JBJS Reviews

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Anterior glenohumeral instability (AGI) is a challenging condition that requires close attention to osseous and soft-tissue abnormalities. The morphometric variance of the periarticular scapular anatomy may be involved in the pathogenesis of recurrent traumatic anterior instability.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A848).

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“…The scapula is a complex anatomical unit, and the coracoid process is a hook-shaped bone structure that projects anterolaterally from the superior aspect of the scapular neck [ 1 ]. The coracoid process has been a popular topic in surgical management, and its morphological variation is related to some specific shoulder pathologies [ 2 , 3 ]. The coracoglenoid space is an arch-shaped space that is delimited by the coracoglenoid distance (CGD) and the coracoglenoid notch (CGN).…”

Section: Introductionmentioning

confidence: 99%

Influence of coracoglenoid space on scapular neck fracture stability: biomechanical study

Chen

Zhang

Pang

et al. 2022

BMC Musculoskelet Disord

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Background The anatomical variation of the coracoglenoid space has the potential to influence the stability of scapular neck fractures. This paper aimed to investigate the mechanical mechanism underlying the influence of different coracoglenoid space types on scapular neck fractures by morphometric analysis and biomechanical experiments. Methods The morphology of 68 dried scapulae (left: 36; right: 32) was studied. Two variables, the length of the coracoglenoid distance (CGD) and the coracoglenoid notch (CGN), were measured. The distribution of CGN/CGD × 100% was used to identify the morphology of the coracoglenoid space. Each specimen was tested for failure under static axial compression loading. The average failure load, stiffness, and energy were calculated. Results Two coracoglenoid space types were identified. The incidence of Type I (‘‘hook’’ shape) was 53%, and that of Type II (‘‘square bracket’’ shape) was 47%. The CGD and CGN were significantly higher for type I than type II (13.81 ± 0.74 mm vs. 11.50 ± 1.03 mm, P < 0.05; 4.74 ± 0.45 mm vs. 2.61 ± 0.45 mm, P < 0.05). The average maximum failure load of the two types was 1270.82 ± 318.85 N and 1529.18 ± 467.29 N, respectively (P = 0.011). The stiffness and energy were significantly higher for type II than type I (896.75 ± 281.14 N/mm vs. 692.91 ± 217.95 N/mm, P = 0.001; 2100.38 ± 649.54 N × mm vs. 1712.71 ± 626.02 N × mm, P = 0.015). Conclusions There was great interindividual variation in the anatomical morphology of the coracoglenoid space. Type I (hook-like) spaces bore lower forces, were less stiff, and bore less energy, which may constitute an anatomical predisposition to scapular neck fractures.

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Influence of coracoid anatomy on the location of glenoid rim defects in anterior shoulder instability: 3D CT-scan evaluation of 51 patients

Cited by 6 publications

References 33 publications

The Glenolabral Articular Disruption Lesion Is a Biomechanical Risk Factor for Recurrent Shoulder Instability

The Glenolabral Articular Disruption Lesion Is a Biomechanical Risk Factor for Recurrent Shoulder Instability

The Trillat Procedure for Anterior Glenohumeral Instability

Influence of coracoglenoid space on scapular neck fracture stability: biomechanical study

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