Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

肩膀 后肩 医学 不稳定性 矢状面 肩峰 口腔正畸科 肩袖 解剖 外科 物理 机械
作者
Dominik C. Meyer,Lukas Ernstbrunner,Glenn Boyce,Mohamed A. Imam,Rany El Nashar,Christian Gerber
出处
期刊:Journal of Bone and Joint Surgery, American Volume [Journal of Bone and Joint Surgery]
卷期号:101 (14): 1253-1260 被引量:48
标识
DOI:10.2106/jbjs.18.00541
摘要

The purpose of this paper was to determine whether acromial morphology influences anteroposterior shoulder stability. We hypothesized that a more horizontal and higher position of the acromion in the sagittal plane would be associated with posterior instability.In this retrospective study, patients with unidirectional posterior instability were age and sex-matched to a cohort of patients with unidirectional anterior instability. Both cohorts were compared with a control group of patients with no instability and no degenerative glenohumeral (rotator cuff and/or joint surface) or acromial changes. Measurements on radiographs included posterior acromial tilt, anterior and posterior acromial coverage (AAC and PAC), posterior acromial height (PAH), and the critical shoulder angle (CSA).The number of patients enrolled in each instability group was 41, based on a priori power analysis. The control group consisted of 53 shoulders. Of the measured anatomic factors, PAH showed the most significant association with posterior instability (odds ratio [OR] = 1.8; p < 0.001) in the logistic regression model. PAH was significantly greater in the posterior instability group compared with the anterior instability group (30.9 versus 19.5 mm; p < 0.001). With a cutoff value of PAH of 23 mm, the OR for posterior instability was 39. Shoulders with posterior instability were also significantly different from normal shoulders with regard to PAH (p < 0.001), AAC (p < 0.001), and PAC (p < 0.001) whereas, in the shoulders with anterior instability, all of these values except the AAC (p = 0.011) did not differ from those of normal shoulders.Specific acromial morphology is significantly associated with the direction of glenohumeral instability. In shoulders with posterior instability, the acromion is situated higher and is oriented more horizontally in the sagittal plane than in normal shoulders and those with anterior instability; this acromial position may provide less osseous restraint against posterior humeral head translation. A steep "Swiss chalet roof-type" acromion virtually excluded recurrent posterior instability in an albeit relatively small cohort of patients. Additional investigation is needed to determine the relevance of these findings for future treatment.Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
香蕉觅云应助科研通管家采纳,获得10
刚刚
cdercder应助科研通管家采纳,获得30
刚刚
充电宝应助科研通管家采纳,获得10
刚刚
李爱国应助科研通管家采纳,获得10
刚刚
FashionBoy应助科研通管家采纳,获得10
刚刚
英俊的铭应助科研通管家采纳,获得10
刚刚
南北应助科研通管家采纳,获得10
刚刚
大刀开口完成签到,获得积分10
刚刚
Owen应助科研通管家采纳,获得10
刚刚
丘比特应助科研通管家采纳,获得10
刚刚
hzc应助科研通管家采纳,获得10
刚刚
充电宝应助科研通管家采纳,获得10
1秒前
1秒前
852应助科研通管家采纳,获得10
1秒前
咕咕发布了新的文献求助10
1秒前
violinsj完成签到,获得积分0
1秒前
ykyin发布了新的文献求助10
1秒前
nz发布了新的文献求助30
2秒前
Jrssion完成签到,获得积分10
3秒前
直率的钢铁侠完成签到,获得积分10
4秒前
MiSD完成签到,获得积分10
5秒前
大刀开口发布了新的文献求助30
6秒前
wj18637196763完成签到,获得积分10
7秒前
香蕉觅云应助zxj采纳,获得10
7秒前
7秒前
南医李云龙完成签到,获得积分20
8秒前
CodeCraft应助biofresh采纳,获得30
8秒前
Jeamren完成签到,获得积分10
10秒前
1234完成签到 ,获得积分10
10秒前
H华ua应助吨吨喝水采纳,获得10
11秒前
不安慕蕊完成签到,获得积分10
11秒前
科目三应助笑点低的傲白采纳,获得10
11秒前
jzyy完成签到 ,获得积分10
12秒前
杨媛完成签到,获得积分20
13秒前
大喜完成签到,获得积分10
14秒前
ykyin完成签到,获得积分20
14秒前
lcdamoy发布了新的文献求助10
16秒前
wanci应助咕咕采纳,获得10
16秒前
lzl008完成签到 ,获得积分10
16秒前
机灵柚子应助elisa828采纳,获得10
17秒前
高分求助中
Continuum Thermodynamics and Material Modelling 3000
Production Logging: Theoretical and Interpretive Elements 2700
Les Mantodea de Guyane Insecta, Polyneoptera 1000
Structural Load Modelling and Combination for Performance and Safety Evaluation 1000
Conference Record, IAS Annual Meeting 1977 820
電気学会論文誌D(産業応用部門誌), 141 巻, 11 号 510
Typology of Conditional Constructions 500
热门求助领域 (近24小时)
化学 材料科学 生物 医学 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 量子力学 光电子学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3571662
求助须知:如何正确求助?哪些是违规求助? 3142176
关于积分的说明 9445995
捐赠科研通 2843587
什么是DOI,文献DOI怎么找? 1562944
邀请新用户注册赠送积分活动 731458
科研通“疑难数据库(出版商)”最低求助积分说明 718551