Analysis of glenohumeral morphological factors for anterior shoulder instability and rotator cuff tear by magnetic resonance imaging.

OBJECTIVE: The aim of this study was to investigate whether there are glenohumeral morphological differences between normal population, glenohumeral instability, and rotator cuff pathology. METHOD: In this study, shoulder magnetic resonance (MR) images of 150 patients were evaluated. Patients included in the study were studied in three groups of 50 individuals: patients with anterior shoulder instability in group 1, patients with rotator cuff tear in group 2, and control subjects without shoulder pathology in group 3. RESULTS: There were statistically significant differences between groups in evaluations for glenoid version, glenoid coronal height, glenoid coronal diameter, humeral axial and coronal diameters, and coracohumeral interval distances. Significant differences were observed between groups 2 and 3 in glenoid axial diameter, glenoid coronal height, glenoid depth, humeral coronal diameter, and coracohumeral distances. CONCLUSION: The results obtained in this study suggest that glenoid version, glenoid coronal height and diameter, humeral diameter, and coracohumeral interval parameters in glenohumeral morphology-related parameters in patients with anterior instability are different from those of normal population and patients with rotator cuff pathology. In cases where there is a clinically difficult diagnosis, these radiological measurements will be helpful to clinicians in diagnosis and treatment planning, especially in cases of treatment-resistant cases.

Comparison of different femoral fixation implants and fit techniques for tunnel widening and clinical outcome in ACL reconstruction using hamstring autograft.

PURPOSE: The purpose of the current study is to investigate in different femoral fixation devices whether tight (undersize drilled) fit technique decreases the tunnel widening and improves the clinical outcome compared to conventional technique in ACL reconstruction using hamstring tendon autograft. METHODS: 93 patients, who underwent Arthroscopic ACL reconstruction whether cortical-cancellous suspension (CP) or cortical suspension (BF) used as fixation device for the hamstring tendon autograft, were included in the study. The cases also grouped as undersize drilled (tight fit) and normal drilled (normal fit) according to their autograft size. There was no difference in demographic data of these four subgroups (CP-TF, CP-NF, BF-TF, and BF-NF) preoperatively. RESULTS: The patients, who had been followed for at least 2 years were included in the study. They were looked for their clinical outcome (Lysholm and IKDC scoring), tunnel widening (on AP and lateral radiographs), and also anterior translation. The BF-TF subgroup showed significantly the best clinical results compared to other three subgroups. There was no difference between BF-TF, CP-TF, and CP-NF in terms of tunnel widening. CONCLUSION: Button fixation of femoral side in ACL reconstruction surgery has good clinical outcome and lower complication rate. Undersize drilling might be preferred in button fixation in order to reduce TW and improve stability and clinical satisfaction. LEVEL OF EVIDENCE: Therapeutic case series, Level IV.