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Forschungsdatenbank PMU-SQQUID

Defect Characteristics of Reverse Hill-Sachs Lesions.
Moroder, P; Tauber, M; Scheibel, M; Habermeyer, P; Imhoff, AB; Liem, D; Lill, H; Buchmann, S; Wolke, J; Guevara-Alvarez, A; Salmoukas, K; Resch, H;
Am J Sports Med. 2016; 44(3):708-714
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Moroder Philipp
Resch Herbert
Tauber Mark

Abstract

BACKGROUND
Little scientific evidence regarding reverse Hill-Sachs lesions (RHSLs) in posterior shoulder instability exists. Recently, standardized measurement methods of the size and localization were introduced, and the biomechanical effect of the extent and position of the defects on the risk of re-engagement was determined.
To analyze the characteristics and patterns of RHSLs in a large case series using standardized measurements and to interpret the results based on the newly available biomechanical findings.
Case series; Level of evidence, 4.
In this multicenter study, 102 cases of RHSLs in 99 patients were collected from 7 different shoulder centers between 2004 and 2013. Patient- as well as injury-specific information was gathered, and defect characteristics in terms of the size, localization, and depth index were determined on computed tomography or magnetic resonance imaging scans by means of standardized measurements. Additionally, the position (gamma angle) of the posterior defect margin as a predictor of re-engagement was analyzed.
Three types of an RHSL were distinguished based on the pathogenesis and chronicity of the lesion: dislocation (D), locked dislocation (LD), and chronic locked dislocation (CLD). While the localization of the defects did not vary significantly between the subgroups (P = .072), their mean size differed signficantly (D: 32.6° ± 11.7°, LD: 49.4° ± 17.2°, CLD: 64.1° ± 20.7°; P < .001). The mean gamma angle as a predictor of re-engagement was similarly significantly different between groups (D: 83.8° ± 14.5°, LD: 96.5° ± 17.9°, CLD: 108.7° ± 18.4°; P < .001). The orientation of the posterior defect margin was consistently quite parallel to the humeral shaft axis, with a mean difference of 0.3° ± 8.1°.
The distinction between the 3 different RHSL types based on the pathogenesis and chronicity of the defect helps identify defects prone to re-engagement. The gamma angle as a measurement of the position of the posterior defect margin and therefore a predictor of re-engagement varies significantly between the defect types.


Useful keywords (using NLM MeSH Indexing)

Adult

Biomechanical Phenomena

Female

Humans

Humerus/diagnostic imaging*

Humerus/pathology

Joint Instability/diagnostic imaging*

Joint Instability/etiology

Joint Instability/pathology

Male

Middle Aged

Recurrence

Shoulder/diagnostic imaging

Shoulder Dislocation/complications

Shoulder Dislocation/diagnostic imaging*

Shoulder Dislocation/pathology

Shoulder Fractures/complications

Shoulder Fractures/diagnostic imaging*

Shoulder Fractures/pathology

Shoulder Joint/diagnostic imaging*

Shoulder Joint/pathology

Tomography, X-Ray Computed/methods


Find related publications in this database (Keywords)

reverse Hill-Sachs lesion
posterior shoulder instability
posterior shoulder dislocation
locked dislocation
chronic locked dislocation
gamma angle