Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Aug 22;17(1):357.
doi: 10.1186/s12891-016-1210-9.

Effect of glenoid concavity loss on shoulder stability- a case report in a professional wrestler

Philipp Moroder  1   2 , Franziska Haniel  3 , Michael Quirchmayr  3 , Eva Schulz  3 , Manfred Eppel  3 , Nicholas Matis  3 , Alexander Auffarth  3 , Herbert Resch  3
Affiliations
Case Reports

Effect of glenoid concavity loss on shoulder stability- a case report in a professional wrestler

Philipp Moroder et al. BMC Musculoskelet Disord. .

Abstract

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.

Keywords: Bony Bankart repair; Bony Shoulder Stability Ratio; Glenoid defect; Shoulder instability.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Schematic drawings of a gleno-humeral joint with illustrated translational force (T), compressive force (C), resulting joint force vector (R), joint radius (r), and concavity depth (d). The geometrical measurements and force vectors can be used to calculate the Bony Shoulder Stability Ratio (BSSR) as previously described [10]
Fig. 2
Fig. 2
No loss of glenoid surface area or diameter can be detected on the preoperative 3DCT scans. However, a dimished glenoid concavity can be detected on the axial CT scans
Fig. 3
Fig. 3
Intraoperative arthroscopic images show the impacted anterior glenoid rim with attached capsulo-labral complex which was mobilized, reduced, and stabilized by percutaneous screw insertion as described by Tauber et al. [11]
Fig. 4
Fig. 4
The patient competing in a wrestling competition 6 months after surgery
Fig. 5
Fig. 5
The postoperative CT scans 1 day after surgery show the reconstructed anterior glenoid rim with deepened glenoid concavity
Fig. 6
Fig. 6
A slight remodeling process of the reconstructed glenoid concavity is visible 1 year after surgery. The screw head is prominent however not lying intaarticular, therefore resulting in no restraints for the patient
See this image and copyright information in PMC

References

    1. Griffith JF, Antonio GE, Yung PS, Wong EM, Yu AB, Ahuja AT, Chan KM. Prevalence, pattern, and spectrum of glenoid bone loss in anterior shoulder dislocation: CT analysis of 218 patients. AJR Am J Roentgenol. 2008;190(5):1247–54. doi: 10.2214/AJR.07.3009. - DOI - PubMed
    1. Nakagawa S, Mizuno N, Hiramatsu K, Tachibana Y, Mae T. Absorption of the bone fragment in shoulders with bony Bankart lesions caused by recurrent anterior dislocations or subluxations: when does it occur? Am J Sports Med. 2013;41(6):1380–6. doi: 10.1177/0363546513483087. - DOI - PubMed
    1. Moroder P, Tauber M, Hoffelner T, Ernstbrunner L, Sattler C, Auffarth A, Resch H. The medial-ridge sign as an indicator of anterior glenoid bone loss. J Shoulder Elbow Surg. 2013;22(10):1332–7. doi: 10.1016/j.jse.2013.03.005. - DOI - PubMed
    1. Yamamoto N, Itoi E, Abe H, Kikuchi K, Seki N, Minagawa H, Tuoheti Y. Effect of an anterior glenoid defect on anterior shoulder stability: a cadaveric study. Am J Sports Med. 2009;37(5):949–54. doi: 10.1177/0363546508330139. - DOI - PubMed
    1. Yamamoto N, Muraki T, Sperling JW, Steinmann SP, Cofield RH, Itoi E, An KN. Stabilizing mechanism in bone-grafting of a large glenoid defect. J Bone Joint Surg Am. 2010;92(11):2059–66. doi: 10.2106/JBJS.I.00261. - DOI - PubMed

Publication types

MeSH terms