Dataset Information

Posterior chondrolabral cleft: clinical significance and associations with shoulder instability.

ABSTRACT:

Background

A high signal intensity cleft between the labrum and articular cartilage of the posterior glenoid is commonly visible on MRI and has been suggested to be anatomic variation [3, 10, 23]. The association of a posterior cleft with variations in glenoid morphology or with shoulder instability is unknown.

Questions/purposes

The purposes of this study were to determine if posterior chondrolabral clefts are associated with variations in glenoid morphology, and to determine if they are associated with shoulder instability.

Patients and methods

Shoulder MRI was performed in 1,264 shoulders, 1,135 male (89.8%), and 129 female (10.2%). A musculoskeletal radiologist blinded to history and outcomes evaluated the MR images for linear high signal intensity at the posterior chondrolabral junction and a rounded or truncated contour of the posterior glenoid. Glenoid version and depth were measured. Patients were followed prospectively for shoulder instability for 4 years. Univariate and multivariate statistical analysis were performed.

Results

Posterior chondrolabral cleft was present in 114/1,264. Posterior chondrolabral cleft was associated with a rounded or truncated posterior glenoid. There were 9.5° retroversion in shoulders with a posterior cleft, and 7.7° retroversion in shoulders without a cleft. Shoulders with a posterior chondrolabral cleft were more likely to develop shoulder instability.

Conclusions

Posterior chondrolabral clefts are not uncommon on MRI. They are associated with a rounded or truncated posterior glenoid and a small but significant increase in glenoid retroversion. They are associated with shoulder instability.

SUBMITTER: Campbell SE

PROVIDER: S-EPMC4171442 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Publications

Posterior chondrolabral cleft: clinical significance and associations with shoulder instability.

Campbell Scot E SE Dewitt Robert M RM Cameron Kenneth L KL Thompson Adrianne K AK Owens Brett D BD

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20140808 3

<h4>Background</h4>A high signal intensity cleft between the labrum and articular cartilage of the posterior glenoid is commonly visible on MRI and has been suggested to be anatomic variation [3, 10, 23]. The association of a posterior cleft with variations in glenoid morphology or with shoulder instability is unknown.<h4>Questions/purposes</h4>The purposes of this study were to determine if posterior chondrolabral clefts are associated with variations in glenoid morphology, and to determine if ...[more]

PMID: 25264436

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Project description:BackgroundPathological muscle activation patterns of the external rotators and periscapular muscles can result in posterior positional functional shoulder instability (PP-FSI). In several patients, physical therapy and surgical treatment are not successful.PurposeThe shoulder-pacemaker treatment concept was evaluated prospectively in patients with PP-FSI and previously failed conventional therapy attempt.Study designCase series; Level of evidence, 4.MethodsA negative selection of 24 consecutive cases of noncontrollable PP-FSI in 16 patients with previously failed conventional therapy were included in this prospective study. The shoulder-pacemaker treatment consisted of an electrical muscle stimulation-based therapy protocol with 9 to 18 one-hour treatment sessions. Two patients were excluded because of nonadherence to the training schedule, leaving a final study cohort of 21 cases in 14 patients. Follow-up included assessment of clinical function, impairment during daily activities and sports, satisfaction, Western Ontario Shoulder Instability Index (WOSI), Rowe score, and Subjective Shoulder Value at 0 weeks, 2 weeks, 4 weeks, 3 months, 6 months, 12 months, and 24 months after intervention.ResultsWOSI, Subjective Shoulder Value, and Rowe score showed a highly significant improvement at all time points of follow-up (P < .001). Young age (P = .005), low weight (P = .019), shoulder activity level (P = .003), unilateral affliction (P = .046), and higher baseline WOSI score (P = .04) were associated with a better treatment effect. Cases with increased glenoid retroversion, posterior scapulohumeral decentering, and dysplastic bony glenoid shape showed a trend toward shorter treatment effect duration. No complications during the intervention or follow-up period were observed.ConclusionThe shoulder-pacemaker therapy concept is an effective treatment with rapid improvement and sustained outcome over the course of 2 years in patients with noncontrollable PP-FSI with previously failed conventional treatment. Young and more athletic patients with lower weight and unilateral pathology respond best to the treatment.

Dataset Information

Posterior chondrolabral cleft: clinical significance and associations with shoulder instability.

Background

Questions/purposes

Patients and methods

Results

Conclusions

Publications

Posterior chondrolabral cleft: clinical significance and associations with shoulder instability.

Similar Datasets

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