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Traumatic anterior glenohumeral instability: quantification of glenoid bone loss by spiral CT

La quantificazione del difetto osseo glenoideo nell’instabilità traumatica gleno-omerale anteriore mediante TC spirale

  • Musculoskeletal Radiology/Radiologia Muscolo-Scheltrica
  • Published:
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Abstract

Purpose

We evaluated the role of computed tomography (CT) for quantifying glenoid bone defects in patients with anterior glenohumeral instability and assisting in planning the most appropriate type of surgery.

Materials and methods

From January to November 2006, 93 patients were studied by spiral CT with multiplanar reconstructions (MPR) for recurrent posttraumatic anteroinferior instability, chronic multidirectional instability and recurrent glenohumeral dislocation after surgical stabilisation.

Results

Quantitative CT enabled us to measure bone defects of the anteroinferior glenoid in terms of area (mm2) or surface percentage. Glenoid osseous defects were classified as small (<15%), medium (15%–20%), and large (>20%).

Conclusions

CT quantification of glenoid bone loss is very accurate as well as rapid, simple and easily reproducible. CT therefore provides an important contribution to preoperative selection of patients, assisting in directing those with <20% bone loss towards arthroscopic capsular repair.

Riassunto

Obiettivo

Valutare l’efficacia della TC nel quantificare esattamente il deficit osseo glenoideo in pazienti con instabilità gleno-omerale antero-inferiore, per la pianificazione del corretto approccio chirurgico.

Materiali e metodi

Nel periodo compreso tra gennaio e novembre 2006, sono stati sottoposti a TC spirale e successive elaborazioni MPR (Multi-Planar-Recostruction), 93 pazienti giunti alla nostra osservazione per instabilità recidivante post-traumatica anteroinferiore, instabilità cronica multidirezionale e recidiva di lussazione dopo intervento di stabilizzazione.

Risultati

La valutazione quantitativa ha permesso di calcolare con esattezza il deficit osseo del bordo glenoideo antero-inferiore in termini di area (espressa in mm2) o di percentuale di superficie. Le dimensioni del difetto sono stato classificate come: piccolo (<15%), medio (tra il 15% ed il 20%) e grande (>20%).

Conclusioni

La metodica da noi utilizzata rende possibile quantificare con estrema precisione il deficit osseo, con una tecnica semplice, rapida e facilmente riproducibile, fornendo così un contributo fondamentale nella selezione pre-operatoria dei pazienti, indirizzando verso l’intervento di capsuloplastica artroscopica i pazienti con un difetto osseo inferiore al 20%.

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Authors and Affiliations

  1. Unità Operativa Complessa di Diagnostica per Immagini, Presidio Ospedaliero dei Pellegrini, ASL Napoli 1, Via Portamedina alla Pignasecca 41, 80134, Napoli, Italy

    G. d’Elia, A. Di Giacomo, P. D’Alessandro & L. C. Cirillo

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  1. G. d’Elia
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  2. A. Di Giacomo
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  3. P. D’Alessandro
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  4. L. C. Cirillo
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Correspondence to L. C. Cirillo.

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d’Elia, G., Di Giacomo, A., D’Alessandro, P. et al. Traumatic anterior glenohumeral instability: quantification of glenoid bone loss by spiral CT. radiol med 113, 496–503 (2008). https://doi.org/10.1007/s11547-008-0274-5

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  • DOI: https://doi.org/10.1007/s11547-008-0274-5

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