Characteristics of High-Risk Bipolar Bone Loss Lesions Using 3-Dimensional Imaging.

IF 2.4 3区医学 Q2 ORTHOPEDICS

Orthopaedic Journal of Sports Medicine Pub Date : 2024-12-04 eCollection Date: 2024-12-01 DOI:10.1177/23259671241297071

Petar Golijanin, Justin W Arner, Claire B Ryan, Qais Zai, Liam A Peebles, Annalise M Peebles, Phob Ganokroj, Ryan J Whalen, Stephanie K Eble, Danielle Rider, Srdjan Ninković, Matthew T Provencher

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引用次数: 0

Abstract

Background: The concept of on-track versus off-track bone lesions in glenohumeral instability continues to evolve. Although much has been ascertained from an original biomechanical model, bony pathological changes, especially on 3-dimensional (3D) imaging, have not been fully evaluated.

Purpose: To compare the differences in on-track versus off-track lesions to characterize glenoid and humeral head bone defects using 3D modeling software.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: A consecutive cohort of 75 patients with recurrent anterior instability, with evidence of Hill-Sachs lesions (HSLs) and glenoid bone loss (GBL) and a mean age of 27.1 years (range, 18-48 years), were reviewed. 3D models of unilateral proximal humeri and glenoids were reconstructed. The volume, surface area, width, and depth of identified HSLs were quantified, along with their location (medial, superior) and orientation (Hill-Sachs angle). The percentage, width, and length of GBL as well as the glenoid track status were calculated. The on-track and off-track groups were compared using the Mann-Whitney U test.

Results: The off-track group had greater HSL surface area (374.23 vs 272.64 mm², respectively; P = .001), more HSL medialization (14.96 vs 17.62 mm, respectively; P = .028), greater HSL volume (603.08 vs 433.61 mm³, respectively; P = .007), and a greater mean HSL width (16.06 vs 11.53 mm, respectively; P = .001) than the on-track group. The off-track group also had greater GBL (22.55% vs 17.73%, respectively; P = .037), a greater GBL width (6.92 vs 3.58 mm, respectively; P < .001), and a greater GBL length (21.61 vs 16.1mm, respectively; P = .015) than the on-track group. Further analysis of large off-track lesions revealed a greater Hill-Sachs angle (33.16° vs 26.20°, respectively; P = .035) and a more superior extent of HSLs compared with borderline off-track and on-track lesions.

Conclusion: Off-track lesions were found to have larger GBL, a larger HSL width, a more medialized HSL, and greater HSL surface area. This study outlines the specific characteristics of high-risk bipolar bone loss lesions to simplify the identification of patients in a clinical setting and aid in appropriate treatment planning.

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高风险双极骨丢失病变的三维成像特征。

背景：肱骨盂不稳中骨轨内病变与骨轨外病变的概念在不断发展。尽管从原始的生物力学模型中已经确定了很多，但骨病理变化，特别是三维（3D）成像，尚未得到充分评估。目的：利用三维建模软件比较肱骨关节和肱骨头骨缺损在轨迹上和轨迹外病变的差异。研究设计：横断面研究；证据水平，3。方法：回顾性分析75例复发性前路不稳患者，伴有Hill-Sachs病变（HSLs）和盂骨丢失（GBL），平均年龄27.1岁（18-48岁）。重建单侧肱骨近端和关节盂的三维模型。定量鉴定出的hsl的体积、表面积、宽度和深度，以及它们的位置（内侧、上部）和取向（Hill-Sachs角）。计算GBL的百分比、宽度和长度以及关节盂轨迹状态。使用Mann-Whitney U检验比较在轨组和非在轨组。结果：离轨组HSL表面积较大（分别为374.23 mm2和272.64 mm2）；P = .001)，更多的HSL媒体化(分别为14.96 vs 17.62 mm；P = 0.028)，更大的HSL体积(分别为603.08 vs 433.61 mm3；P = .007)，平均HSL宽度更大(分别为16.06 vs 11.53 mm；P = .001)。偏离轨道组的GBL也更高（分别为22.55%和17.73%）；P = 0.037)，更大的GBL宽度(分别为6.92 vs 3.58 mm；P < 0.001)，且GBL长度较大(分别为21.61 vs 16.1mm；P = .015)。进一步分析较大的偏离轨道病变，发现Hill-Sachs角更大（分别为33.16°和26.20°）；P = 0.035)，并且与边缘偏离和轨迹病变相比，hsl的程度更优越。结论：偏离轨道的病变具有更大的GBL，更大的HSL宽度，更中间化的HSL，更大的HSL表面积。本研究概述了高风险双相骨丢失病变的具体特征，以简化临床环境中患者的识别，并有助于制定适当的治疗计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

7.70%

发文量

876

审稿时长

12 weeks

期刊介绍： The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).