90 research outputs found
Effect of glenoid concavity loss on shoulder stability- a case report in a professional wrestler
Background Current glenoid defect measurement techniques only quantify bone
loss in terms of defect diameter or surface. However, the glenoid depth plays
an important role in shoulder stabilization by means of concavity compression.
Case presentation We present a case of a professional wrestler who suffered
from anterior shoulder instability after sustaining a bony Bankart lesion
without loss of glenoid surface area but flattening of the concavity due to
medialization of the fragment. The patient’s glenoid concavity was
reconstructed arthroscopically by reduction and percutaneous screw fixation of
the bony fragment along with a capsulo-ligamentous shift. Changes of the
glenoid concavity with according alterations in the Bony Shoulder Stability
Ratio (BSSR) were analyzed on pre-op, post-op, and follow-up CT scans.
Postoperative CT scans revealed a deepened concavity (3.3 mm) and improved
BSSR (46.1 %) compared to pre-op scans (0.7 mm; 11.3 %). Follow-up CT scans
showed a slight remodeling of the glenoid concavity (3.2 mm) with steady BSSR
(44.7 %). Conclusion This case shows that the passive stabilizing effect of
the glenoid can be compromised by loss of concavity despite the absence of
loss of articular surface. Therefore, addressing the concavity loss and
resulting reduction of the BSSR is recommended in these cases. Bony Bankart
repair was successful in restoring the BSSR of the patients shoulder as
determined by mathematical calculations based on CT scans
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