Glenoid Anterior Derinlik Açısı ve Glenoid Versiyonun Tekrarlayan Anterior Glenohumeral Dislokasyonlara Etkisi
Abstract
Amaç: Anterior dislokasyonlar Glenohumeral Eklem Dislokasyonlarının (GED) %85'ini oluşturur ve erken cerrahi önerilir. Bu çalışmanın amacı, Glenoid Anterior Derinlik Açısı (GADA) ve Glenoid Versiyon Açısı'nın (GVA) tekrarlayan anterior glenohumeral çıkıklar (TAGD) üzerindeki etkilerini araştırmaktır. Aynı zamanda, TAGD'de glenoid anatomik formundan kaynaklanan riski belirlemeyi ve cerrahi planlamayı aydınlatmayı amaçladık.
Gereç ve Yöntemler: Çalışmamız kontrollü ve tek kör olarak tasarlanmıştır. Toplam 41 ön çıkık bir yılda en az üç kez tekrarlanmış ve manyetik rezonans görüntüleme (MRG) ile belgelenmiştir. 47 kontrol grubu hastadan elde edilen MRG'leri çalışmaya dahil edilmiştir. Eksenel MR görüntülerinden GVA ve GADA ölçüldü.
Bulgular: Cinsiyetin gruplar arasında dağılımı benzerdi. Hastaların yaş ortalaması 40,38 ± 15,96 yaş idi. GADA ve GVA değerleri sırasıyla 26.90 ± 5.62 (11-37.7) ve 11.74 ± 4.31 (1.8-20.4) olarak ölçüldü. GADA ölçümleri açısından gruplar arasında 0.927 uyumu istatistiksel olarak anlamlı idi (p = 0.001). Birinci ve ikinci gözlemcinin ilk GADA ölçümleri birbiriyle uyumluydu (0.881). Gruplar arasında ortalama GADA değerleri açısından anlamlı fark vardı (p = 0.00, kritik t 1.99). Gruplar arasında ortalama GVA değerleri açısından anlamlı fark vardı (p = 0.00, kritik t1.99).
Sonuç: AGED tanısı olan hastalarda Anterior Glenohumeral Eklem Dislokasyonu (AGED) nüks riski 11,22 ° 'den düşük GRA ve 25,21 °' den düşük GRA varlığında yüksektir.
References
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Abstract
Aim: Anterior dislocations comprise up 85% of Glenohumeral Joint Dislocations (GJD) and early surgery is recommended. The aim of this study was to investigate the effects of Glenoid Anterior Depth Angle (GADA) and Glenoid Version Angle (GVA) on recurrent anterior glenohumeral dislocations (RAGD). At the same time, we also aimed to determine the risk arising from the anatomical form of the glenoid in RAGD and enlight the surgical planning.
Materials and Methods: Our study was designed as controlled and double blind. A total 41 anterior dislocations had repeated at least three times in one year and documented with magnetic resonance imaging (MRI). The MR images obtained from 47 control group patients included the study. GVA and GADAwere measured from axial MR images.
Results: The distribution of sex between the groups was similar. Mean age of the patients was 40.38±15.96 years of age. The values of GADA and GVA were measured as 26.90± 5.62(11-37.7), and 11.74±4.31(1.8-20.4) respectively. The concordance 0.927 between the groups in terms of the measurements of GADA was statistically significant (p=0.001). The first measurements of GADA of first and second observer were in concordance with each other (0.881). There was a significant difference between the groups in terms of average values of GADA (p=0.00, critical t 1.99). There was also significant difference between the groups in terms of average values of GVA (p=0.00, critical t1.99).
Conclusion: The risk of recurrence of Anterior Glenohumeral Joint Dislocation (AGJD) is high in the presence of GVA lower than11.22° and GADA lower than 25.21° in patients with diagnosis of AGJD.
References
- 1. Brophy RH, Marx RG. The treatment of traumatic anterior instability of the shoulder: nonoperative and surgical treatment. Arthroscopy 2009;25:298-304. http://dx.doi.org/10.1016/j.arthro.2008.12.007
- 2. Dodson CC, Cordasco FR. Anterior glenohumeral joint dislocations. Orthop Clin North Am 2008;39:507-18. http://dx.doi.org/10.1016/j. ocl.2008.06.001
- 3. Labriola JE, Lee TQ, Debski RE, McMahon PJ. Stability and instability of the glenohumeral joint: the role of shoulder muscles. J Elbow Shoulder Surg 2005;14:32S-8S. http://dx.doi.org/10.1016/j.jse.2004.09.014
- 4. Rhee YG, Cho NS, Cho SH. Traumatic anterior dislocation of the shoulder: factors affecting the progress of the traumatic anterior dislocation. Clin Orthop Surg 2009;1:188-93. http://dx.doi.org/10. 4055/cios.2009.1.4.188
- 5. Matsumura N, Ogawa K, Ikegami H, Collin P, Walch G, & Toyama Y. Computed tomography measurement of glenoid vault version as an alternative measuring method for glenoid version. Journal of orthopaedic surgery and research, 2014, 9(1), 1.
- 6. Friedman RJ, Hawthorne KB, Genez BM: The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 1992, 74:1032–1037.
- 7. De Wilde LF, Berghs BM, VandeVyver F, Schepens A, Verdonk RC: Glenohumeral relationship in the transverse plane of the body. J Shoulder Elbow Surg 2003, 12:260–267.
- 8. Bryce CD, Davison AC, Lewis GS, Wang L, Flemming DJ, Armstrong AD: Two-dimensional glenoid version measurements vary with coronal and sagittal scapular rotation. J Bone Joint Surg Am 2010, 92:692–699.
- 9. Budge MD, Lewis GS, Schaefer E, Coquia S, Flemming DJ, Armstrong AD: Comparison of standard two-dimensional and three-dimensional corrected glenoid version measurements. J Shoulder Elbow Surg 2011, 20:577–583.
- 10. Samim, M., Virk, M., Mai, D., Munawar, K., Zuckerman, J., & Gyftopoulos, S. (2017). Multilevel glenoid morphology and retroversion assessment in Walch B2 and B3 types. Skeletal radiology, 1-8.
- 11. Hohmann E, Bryant A. Closing or opening wedge high tibial osteotomy: watch out for the slope. Oper Tech Orthop 2007;17:17-38. http:// dx.doi.org/10.1053/j.oto.2006.09.010
- 12. Crall TS, Bishop JA, Guttman D, Kocher M, Bozic K, Lubowitz JH. Cost-effectiveness analysis of primary arthroscopic stabilization versus nonoperative treatment for first-time anterior glenohumeral dislocations. Arthroscopy 2012;12:1755-65. http://dx.doi.org/10.1016/j.arthro.2012.05.885
- 13. Nyffeler RW, Sheikh R, Atkinson TS, Jacob HA, Favre P, Gerber C. Effects of glenoid component version on humeral head displacement and joint reaction forces: an experimental study. J Shoulder Elbow Surg 2006;15:625-9. http://dx.doi.org/10.1016/j.jse.2005.09.016
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | MAKALELER |
| Authors | |
| Publication Date | November 27, 2020 |
| Published in Issue | Year 2020 Volume: 4 Issue: 3 |
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