1998 Volume 22 Issue 2 Pages 327-330
Techniques and clinical results of arthroscopic surgery for an anterior dislocation or subluxation of the shoulder are influenced by the adhesion between the ligament-labrum complex (complex) and the anterior glenoid wall. The present study was undertaken to determine whether the adhesion could be predicted by CT-arthrography (CT-A).
CT-As of 103 patients with 51 recurrent anterior dislocations,49 subluxations and 3 initial anterior dislocations were analyzed. The patients were 74 males and 29 females, aged from 13 to 50 years (mean 23).
CT-A findings were classified into three types. Type A: with Air adjacent to the anterior glenoid s urface, type B: with Bony fragment and type S: with a Soft tissue shadow on the anterior glenoid. Adhesion of the complex to the glenoid wall was confirmed by arthroscopic observations.
Fifty-one cases were classified as type A. Thirty were as type B and the othe r 22 were as type S. No adhesion was found in type A, while the bony fragment was firmly attached to the glenoid in type B cases. The detachment procedure of the adherent complex from the anterior glenoid was necessary in arthroscopic Bankart's repair in 18 cases of type S (82%). The diagnostic values of type A and type S were as follows: sensitivity=81.2%, specificity=100% and accuracy=94.5%
Among 51 cases with type A,76% of the cases were di agnosed as recurrent dislocations. Among those with type B and type S, the ratios of dislocation were 20% and 32%, respectively.
The adhesion between the complex and the anterior glenoid can be predicte d by CT-As focusing on air and the soft tissue shadows adjacent to the anterior glenoid wall.
