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Archives of Orthopaedic and Trauma Surgery

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02-02-2023 | Shoulder Instability | Arthroscopy and Sports Medicine

Is lesser tuberosity morphology related to subscapularis tears and anterior shoulder instability?

Authors: Haluk Yaka, Mustafa Özer, Ulunay Kanatlı

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2023

Abstract

Purpose

Although the morphological relationship of the scapula and the humeral head has been claimed to be related to shoulder pathologies, few studies examined the relationship between subscapularis (Ssc) tears and lesser tuberosity (LT)—humeral head (HH) and between Ssc tears and HH—glenoid. This study aims to evaluate the relationship of LT with HH and glenoid in patients with Ssc tears and anterior shoulder instability (ASI). We hypothesized that the glenoid, HH, and their combined relationship with LT may impact Ssc tears and ASI.

Material and methods

The study included 34 patients with ASI, 28 patients with isolated Ssc tears, and 40 patients as the control group. The radius of HH (Hr), the distance between the center of HH and LT (LTr), and the glenoid radius (Gr) were measured in shoulder magnetic resonance (MR) images. The LTr to Hr (LTr/Hr) ratio was defined as the lesser tuberosity-humeral head index (LTHHI), whereas the LTr to Gr (LTr/Gr) ratio was defined as the lesser tuberosity-glenoid index (LTGI). The three groups were compared regarding LTHHI, LTGI, LTr, Hr, and Gr.

Results

There was a significant difference between each group concerning LTGI (p < 0.001). LTGI values below 1.99 showed 93.1% sensitivity and 93.3% specificity for Ssc tears, while values above 2.24 showed 86.7% sensitivity and 86.2% specificity for ASI. Also, there was a significant difference when the groups were compared for LTHHI (p < 0.001). This rate was lowest for Ssc tears, and LTHHI values below 1.17 showed 82.8% sensitivity and 80.1% specificity.

Conclusion

LTGI may be a new predictive factor showing 93.1% sensitivity and 93.3% specificity for Ssc tears and 86.7% sensitivity and 86.2% specificity for ASI. In addition, LTHHI may be a new predictive factor showing 82.8% sensitivity and 80.1% specificity for Ssc tears.

Level of evidence

III retrospective comparative study.

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Title: Is lesser tuberosity morphology related to subscapularis tears and anterior shoulder instability?
Authors: Haluk Yaka
Mustafa Özer
Ulunay Kanatlı
Publication date: 02-02-2023
Publisher: Springer Berlin Heidelberg
Keyword: Shoulder Instability
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 8/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04790-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is lesser tuberosity morphology related to subscapularis tears and anterior shoulder instability?

Abstract

Purpose

Material and methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Material and methods

Results

Conclusion

Level of evidence

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