Abstract: Purpose: Is to predict the risk factors causing gleno-humeral bone loss and affecting its size in patients with traumatic anterior shoulder instability.
Patients and methods: At a median follow-up of 26 months, 60 patients having unilateral traumatic anterior shoulder instability were included in the study. The proposed risk factors for gleno-humeral bone loss were recorded. All patients underwent clinical evaluation and scoring. True AP radiography and CT scan of the shoulder were done to all patients to detect and quantify gleno-humeral bone loss. The collected data were analyzed to detect the factors correlating with the presence of gleno-humeral bone.
Results: The number of dislocations was a significant risk factor for the presence of glenoid bone loss and large glenoid defect (P value: 0.023 and 0.001 respectively). Moreover, it was a significant risk factor for longer and deeper Hill-Sachs lesions (P value: 0.002 and 0.004 respectively). The age of 1st dislocation < 20 years was a significant risk factor for critical glenoid bone loss of 20% and large glenoid defect (P value: Nil and 0.028 respectively). While age at 1st dislocation >20 years showed a negative correlation against larger Hill-Sachs lesions. Contact sports were a significant risk factor for the presence of glenoid bone loss and deeper Hill-Sachs lesions (P value: 0.002 and 0.003 respectively). Smoking was another but weak risk factor for large glenoid defects and longer Hill-Sachs lesions (P value: 0.050 and 0.034 respectively). The glenoid and humeral head bone loss showed highly significant correlation between each other.
Conclusion: The number of dislocations, young age at 1st dislocation, contact sports and smoking are considered risk factors and predictors for gleno-humeral bone loss in traumatic anterior shoulder instability.
Level of evidence: Case series study; Level of evidence, 4.
