2023 ISAKOS Biennial Congress ePoster
Assessing Bone Loss In The Unstable Shoulder: A Scoping Review
Moin Khan, MD, MSc, FRCSC, Hamilton, ON CANADA
Kyle Gouveia, MD, Hamilton, ON CANADA
Fayyaz Rizvi, BSc, Hamilton, ON CANADA
Danielle Dagher, BHSc, Scarborough, ON CANADA
Timothy Leroux, MD, MEd, FRCSC, Toronto CANADA
Asheesh Bedi, MD, Ann Arbor, MI UNITED STATES
McMaster University , Hamilton, ON, CANADA
FDA Status Not Applicable
Summary
The assessment of glenoid and humeral bone loss essential to treatment decisions for patient with recurrent anterior shoulder instability. Glenoid bone loss is most commonly assessed using cross-sectional imaging, most often 3D CT, and some variation of a best-fit circle applied to the inferior portion of the glenoid. Hill-Sachs lesion assessment was also commonly done using three-dimensional imag
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Abstract
Purpose
The aim of this scoping review is to identify and summarize findings published in the literature over the past five years related to methods for assessment of bone loss in anterior shoulder instability.
Recent Findings: Of the 113 clinical studies included in this review, 76 reported a cutoff for glenoid bone loss when determining the patients indicated for one of the many stabilization procedures investigated. Bone loss on the glenoid side was evaluated most commonly with three-dimensional computed tomography (3D CT), and either linear or surface-area based methods were employed with the use of a best-fit circle. When combined with plain CT, the two methods comprise up 70% of the reported measurement techniques for glenoid bone loss (79 of 113 studies). On the humeral side, Hill-Sachs lesions were assessed more heterogeneously, though plain CT or 3D CT remained the methods of choice in the majority of studies (43 of 68, 63.2%). Lastly, the glenoid track was assessed by 27 of 113 studies (23.9%), again most commonly with 3D CT (13 studies) and plain CT (seven studies).
Summary: The assessment of glenoid and humeral bone loss essential to treatment decisions for patient with recurrent anterior shoulder instability. Glenoid bone loss is most commonly assessed using cross-sectional imaging, most often 3D CT, and some variation of a best-fit circle applied to the inferior portion of the glenoid. Hill-Sachs lesion assessment was also commonly done using three-dimensional imaging; however, there was more variability in assessment methods across studies and there is an obvious need to unify the approach to humeral bone loss assessment for the purposed of improving treatment decisions and to better assess on-track and off-track lesions.