Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability

Abstract Background Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have...

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Main Authors: Noboru Matsumura, Kazuya Kaneda, Satoshi Oki, Hiroo Kimura, Taku Suzuki, Takuji Iwamoto, Morio Matsumoto, Masaya Nakamura, Takeo Nagura
Format: Article
Language:English
Published: BMC 2021-04-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-021-02395-5
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spelling doaj-c893ad5bb9914ec7955c64ce5322d4ab2021-04-18T11:29:23ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-04-0116111010.1186/s13018-021-02395-5Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instabilityNoboru Matsumura0Kazuya Kaneda1Satoshi Oki2Hiroo Kimura3Taku Suzuki4Takuji Iwamoto5Morio Matsumoto6Masaya Nakamura7Takeo Nagura8Department of Orthopedic Surgery, Keio University School of MedicineDepartment of Orthopedic Surgery, Keio University School of MedicineDepartment of Orthopedic Surgery, Keio University School of MedicineDepartment of Orthopedic Surgery, Keio University School of MedicineDepartment of Orthopedic Surgery, Keio University School of MedicineDepartment of Orthopedic Surgery, Keio University School of MedicineDepartment of Orthopedic Surgery, Keio University School of MedicineDepartment of Orthopedic Surgery, Keio University School of MedicineDepartment of Clinical Biomechanics, Keio University School of MedicineAbstract Background Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. Methods A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. Results Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). Conclusions Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations.https://doi.org/10.1186/s13018-021-02395-5Glenohumeral instabilityGlenoid defectHill-Sachs lesionHumeral head defectBipolar lesionShoulder dislocation
collection DOAJ
language English
format Article
sources DOAJ
author Noboru Matsumura
Kazuya Kaneda
Satoshi Oki
Hiroo Kimura
Taku Suzuki
Takuji Iwamoto
Morio Matsumoto
Masaya Nakamura
Takeo Nagura
spellingShingle Noboru Matsumura
Kazuya Kaneda
Satoshi Oki
Hiroo Kimura
Taku Suzuki
Takuji Iwamoto
Morio Matsumoto
Masaya Nakamura
Takeo Nagura
Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
Journal of Orthopaedic Surgery and Research
Glenohumeral instability
Glenoid defect
Hill-Sachs lesion
Humeral head defect
Bipolar lesion
Shoulder dislocation
author_facet Noboru Matsumura
Kazuya Kaneda
Satoshi Oki
Hiroo Kimura
Taku Suzuki
Takuji Iwamoto
Morio Matsumoto
Masaya Nakamura
Takeo Nagura
author_sort Noboru Matsumura
title Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_short Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_full Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_fullStr Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_full_unstemmed Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
title_sort factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability
publisher BMC
series Journal of Orthopaedic Surgery and Research
issn 1749-799X
publishDate 2021-04-01
description Abstract Background Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. Methods A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. Results Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). Conclusions Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations.
topic Glenohumeral instability
Glenoid defect
Hill-Sachs lesion
Humeral head defect
Bipolar lesion
Shoulder dislocation
url https://doi.org/10.1186/s13018-021-02395-5
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