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Measuring 3D In-vivo Shoulder Kinematics using Biplanar Videoradiography
Published on: March 12, 2021
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Editorial Commentary: Delphi Expert Consensus Clarifies Evidence-Based Medicine for Shoulder Instability and Bone
Summary
Anterior glenohumeral instability with significant glenoid bone loss often requires bone grafting. Three-dimensional CT scans are recommended for evaluating bone loss and guiding treatment decisions for shoulder instability.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanics
Background:
- Anterior glenohumeral instability with glenoid bone loss presents a significant clinical challenge.
- Bone augmentation is typically indicated for glenoid bone loss exceeding 20%.
Discussion:
- Expert consensus (Delphi method) highlights the utility of 3D CT for assessing bone loss and failed prior surgeries.
- Standard imaging inadequately quantifies Hill-Sachs lesions.
- Glenoid bone grafting is recommended for bone deficits greater than 20%.
Key Insights:
- 3D CT is crucial for evaluating bone loss in shoulder instability.
- Bone grafting is a key consideration for significant glenoid bone defects.
- Consensus was not reached on several aspects, including MRI for bone loss, arthroscopic Latarjet safety, and rehabilitation protocols.
Outlook:
- Further research is needed to establish consensus on imaging modalities, arthroscopic techniques, and postoperative management for glenohumeral instability with bone loss.
- Standardization of evaluation and treatment protocols will improve outcomes for patients with complex shoulder instability.
