Correlations of coracohumeral ligament and range of motion restriction in patients with recurrent anterior glenohumeral instability evaluated by magnetic resonance arthrography.
BACKGROUND
Evaluation of range of motion (ROM) restriction before treatment of shoulder disorders is important for predicting the final functional outcomes. The purpose of this study was to investigate correlations of thickness of the coracohumeral ligament (CHL) and ROM restriction in patients with recurrent anterior glenohumeral instability.


METHODS
Between January 2005 and March 2015, 181 shoulders (137 male and 44 female patients; mean age, 29.3 years) with recurrent anterior glenohumeral instability treated with an arthroscopic Bankart repair were enrolled in this study. We evaluated preoperative ROM, thickness of the CHL, and obliteration of the subcoracoid fat triangle on magnetic resonance arthrography. ROM measurements, including forward flexion (FF), external rotation with the arm at the side (ER), and hand behind the back (HBB), were made in a standing position.


RESULTS
There were significant negative correlations between FF and age (P < .001) and between HBB and age (P < .001) but not between ER and age (P = .11). The thickness of the CHL significantly increased with age (P < .001). FF, ER, and HBB were significantly restricted in patients with obliteration compared with those without obliteration (P < .001, P = .004, P < .001, respectively).


CONCLUSIONS
Obliteration of the subcoracoid fat triangle and the thickness of the CHL positively correlated with ROM restrictions, and these changes were greater with age in patients with recurrent anterior glenohumeral instability.
Department of Orthopaedic Surgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.
Kenji
K
Kanazawa
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan. Electronic address: hagi@med.tohoku.ac.jp.
Yoshihiro
Y
Hagiwara
Shoulder & Elbow Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan.
Nobuaki
N
Kawai
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
Takuya
T
Sekiguchi
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
Masashi
M
Koide
Department of Orthopaedic Surgery, Matsuda Hospital, Sendai, Miyagi, Japan.
Akira
A
Ando
Shoulder & Elbow Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan.
Hiroyuki
H
Sugaya
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
Eiji
E
Itoi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001175:Arthrography; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008023:Ligaments, Articular / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
CHL thickness; ROM restriction; anterior glenohumeral instability; coracohumeral ligament; magnetic resonance arthrography; subcoracoid fat triangle