Glenoid version is associated with different labrum tear patterns in shoulder instability

Julian Mehl; Jon Hedgecock; Alexander Otto; Eilish Flaherty; Brigitte Jacoby; Jessica DiVenere; Mark Cote; Augustus D Mazzocca

doi:10.1016/j.jse.2020.03.043

Glenoid version is associated with different labrum tear patterns in shoulder instability

J Shoulder Elbow Surg. 2020 Aug;29(8):1642-1649. doi: 10.1016/j.jse.2020.03.043. Epub 2020 Jun 9.

Authors

Julian Mehl¹, Jon Hedgecock², Alexander Otto³, Eilish Flaherty², Brigitte Jacoby², Jessica DiVenere², Mark Cote², Augustus D Mazzocca²

Affiliations

¹ Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA; Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany. Electronic address: julian.mehl@tum.de.
² Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.
³ Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA; Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany; Department of Trauma, Orthopaedic, Plastic and Hand Surgery, University Hospital of Augsburg, Augsburg, Germany.

PMID: 32713468
DOI: 10.1016/j.jse.2020.03.043

Abstract

Background: Previous studies have evaluated glenoid version as a risk factor for anterior and posterior shoulder instability. However, the association of glenoid version with combined anterior-inferior-posterior (>180°) labrum injuries is unknown. The purpose of the present study was to investigate various parameters of glenoid morphology, including version, in >180° labral tears and to compare these values with isolated anterior and isolated posterior tears.

Methods: Magnetic resonance imaging studies from a consecutive series of shoulder instability patients were reviewed by 3 independent observers to measure the parameters of glenoid morphology including superior-inferior and anterior-posterior diameter, diameter ratio, glenoid version using the glenoid vault method, and percentage of glenoid bone loss using the best-fit circle method. These parameters were compared between patients with anterior (group 1), posterior (group 2), and >180° labral tears (group 3). Interobserver reliability coefficients were calculated for all measurements assessed.

Results: There were statistically significant differences for all group comparisons regarding the glenoid version, with group 2 having the most retroversion (19.9° ± 4.71°) followed by group 3 (14.21° ± 4.59°) and group 1 (11.24° ± 5.3°). Group 3 showed the lowest amount of glenoid bone loss; however, the group differences did not reach statistical significance. There was also no statistically significant group difference for the other measured parameters. Interobserver reliability was in the good to excellent range for all measurements.

Conclusions: Combined anterior-inferior-posterior labral tears are associated with an increased amount of glenoid retroversion compared with isolated anterior labral tears. Isolated posterior labral tears have the largest amount of glenoid retroversion of all tear patterns.

Keywords: Shoulder; bone loss; glenoid version; instability; labral tear; morphology.

MeSH terms

Adult
Female
Humans
Joint Instability / diagnosis*
Magnetic Resonance Imaging / methods*
Male
Reproducibility of Results
Rupture
Scapula / diagnostic imaging
Scapula / injuries*
Shoulder Injuries*
Shoulder Joint / diagnostic imaging