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Study: First-time anterior shoulder instability event contributes to glenoid bone loss in athletes

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SAN DIEGO — Athletes had 6.8% glenoid bone loss after a first-time anterior shoulder instability event, with 22.8% glenoid bone loss seen after recurrent instability, according to a presenter at the American Orthopaedic Society for Sports Medicine Annual Meeting.

Jonathan F. Dickens

“There does appear to be a significant contribution of a single instability event on glenoid osseous morphology,” Jonathan F. Dickens, MD, said during his presentation.

Dickens and colleagues performed a prospective cohort study of 714 athletes. Patients were followed for 4 years. At the initial assessment, patients were evaluated for subjective history of shoulder instability. Bilateral shoulder MRIs were collected from all patients with or without a history of shoulder instability. Investigators identified patients who sustained an anterior glenohumeral instability event. MRI post-injury was obtained and then compared with the initial MRI. Glenoid width was measured for all MRIs. Patients with a prior history of shoulder instability were compared based on the calculated projected total glenoid bone loss.

During the 4-year follow-up, 22 athletes (23 shoulders) sustained a first-time anterior instability. There were six athletes with a previous history of instability who sustained recurrent anterior instability. After a single instability event of the glenoid width, investigators noted statistically significant glenoid bone loss.

After a first-time instability event, 52% of shoulders had 5% glenoid bone loss or more; four shoulders had 13.5% glenoid bone loss or more; and no shoulders had 20% glenoid bone loss or more. Investigators found pre-existing glenoid bone loss of 10.2% in athletes with a history of instability, which increased to 22.8% after another instability event. Researchers found greater than 20% glenoid bone loss in all six shoulders with recurrent instability. – by Monica Jaramillo

Reference:

Dickens JF, et al. Paper 141. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 5-9, 2018; San Diego.

Disclosure: The study was funded by Orthopaedic Research and Education Foundation.