2023 ISAKOS Biennial Congress ePoster
Ultrasound Assessment Of Anterior Humeral Head Translation In Patients With Anterior Shoulder Instability
Jumpei Inoue, MD, Pittsburgh, PA UNITED STATES
Tetsuya Takenaga, MD, PhD, Nagoya, Aichi JAPAN
Atsushi Tsuchiya, MD, PhD, Nagoya, Aichi JAPAN
Norio Okubo, MD, Nagoya JAPAN
Satoshi Takeuchi, MD, PhD, Toyohashi JAPAN
Keishi Takaba, MD, PhD, Nagoya, Aichi JAPAN
Masahiro Nozaki, MD, PhD, Nagoya, Aichi JAPAN
Makoto Kobayashi, MD, PhD, Nagoya, Aichi JAPAN
Hiroaki Fukushima, MD, PhD, Nagoya, Aichi JAPAN
Jiro Kato, Nagoya, Aichi JAPAN
Hideki Murakami, MD, PhD, Nagoya JAPAN
Masahito Yoshida, MD, PhD, Nagoya, Aichi JAPAN
Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Aichi, JAPAN
FDA Status Not Applicable
Summary
Anterior humeral head translation was larger at 45° and 90° of shoulder abduction than that at 0°. Increased anterior humeral head translation was associated with female sex irrespective of any abduction angle; other factors, including the increasing number of dislocations or bone loss, were not associated factor with increased anterior humeral head translation
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Abstract
Introduction
Ultrasonography can quantitatively assess anterior humeral head translation at different degrees of shoulder abduction. Risk factors for recurrent shoulder instability have been identified. We hypothesized that number of dislocations or glenoid or humeral bone loss would be associated with more anterior humeral head translation as measured using ultrasound.
Materials And Methods
Thirty-nine patients who underwent surgery for anterior shoulder instability were prospectively studied. Ultrasound assessment of anterior humeral head translation was performed immediately after general anesthesia was induced. The upper arm was placed at 0°, 45°, and 90° of abduction, and a 40-N anterior force was applied to the proximal third of the arm. The distance from the posterior edge of the glenoid to that of the humeral head was measured at each abduction angle using ultrasound with and without a 40-N anterior force, and the anterior humeral head translation was calculated. The differences in translation at each shoulder angle were compared. Additionally, we investigated the association between anterior humeral head translation and demographic, radiographic, and clinical data.
Results
Compared with the anterior humeral head translation at 0° of abduction (5.29 mm), translation was significantly larger at 45° of abduction (8.90 mm, P < .01) and 90° of abduction (9.46 mm, P < .01). Mean translation was significantly larger in female patients than in male patients at all degrees of abduction (P = .036 for all). There was no correlation between anterior humeral head translation at any abduction angle and number of dislocations, clinical data, or radiographic data (including bone loss).
Conclusion
Ultrasound assessment of AHHT showed larger amounts of laxity at 45° and 90° than at 0° of abduction. Anterior glenohumeral laxity was greater in female versus male patients. Glenoid or humeral bone loss did not correlate with AHHT, thereby clarifying that bone loss has no direct effect on measurements of capsular laxity in neutral rotation.