A retrospective analysis of risk factors for the progression of shoulder osteoarthritis after glenoid labrum surgery

doi:10.3877/cma.j.issn.2095-5790.2022.04.008

Abstract

Abstract:

Background

Glenoid fractures are intra-articular fractures with a low incidence, accounting for only 10%-15% of scapular fractures. However, they often lead to the collapse and displacement of the articular surface, change the shape of the glenohumeral joint, and affect the function of the shoulder joint. Due to the joint involvement of such fractures, surgical treatment is often used to restore the patient's shoulder joint function to the maximum extent. Although the long-term efficacy of surgical treatment is good, there are still a series of complications, including nonunion, infection, joint stiffness, and osteoarthritis. Glenohumeral joint osteoarthritis is one of the most severe long-term complications after glenoid internal fixation surgery, manifested as shoulder joint pain and limited mobility. Clinically, many patients who have undergone internal fixation of glenoid fractures or internal fixation of glenoid bone grafts, even with sound reduction and internal fixation, will still have osteoarthritis changes in the shoulder joint in the long term, which seriously affects the prognosis of patients, reduces the quality of life and exercise level.

Objective

To analyze the risk factors for the progression of glenohumeral osteoarthritis in patients undergoing glenoid labrum internal fixation surgery.

Methods

This study retrospectively reviewed patients who underwent glenoid fixation in our department from January 2005 to December 2020, including glenoid fracture internal fixation and glenoid bone defect fixing using a bone graft. Baseline medical history, imaging, surgical, and postoperative follow-up data were collected to summarize the clinical characteristics and analyze the risk factors of osteoarthritis progression.

Results

Overall, 58 patients were included in this study, including 11 patients with osteoarthritis progression after internal glenoid fixation. Multivariate logistic regression analysis suggested that advanced age (P= 0.016) and slight critical shoulder angle (P= 0.002) were independent risk factors for osteoarthritis progression after glenoid internal fixation.

Conclusion

Advanced age and slight critical shoulder angle are independent risk factors for the progression of shoulder osteoarthritis after surgery.

Key words: Glenoid labrum, Shoulder osteoarthritis, Critical shoulder angle

Xiebo You, Di Wu, Zhenyu Ding, Weilin Yu, Yaohua He. A retrospective analysis of risk factors for the progression of shoulder osteoarthritis after glenoid labrum surgery[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2022, 10(04): 338-342.

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URL: https://zhjzwkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5790.2022.04.008

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References 22

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组别	例数	性别（男/女）	年龄（岁，±s）	BMI （±s）	手术侧（右/左）	手术方式（肩关节镜下修补+植骨内固定术/肩盂骨折切开复位内固定术）	手术间隔时间（月，±s）	CSA （±s）	AI （±s）	肩胛盂倾向（下倾/上倾）	LAA （±s）
对照组	47	37/10	40.5±14.2	25.9±2.9	35/12	30/17	0.62±0.56	41.01±5.19	0.82±0.81	9/38	68.11±7.50
骨关节炎组	11	6/5	52.1±14.9	25.7±2.9	7/4	5/6	0.40±0.32	34.63±5.03	0.80±0.09	1/10	69.24±9.42
检验值		x²=2.718	t=2.340	t=0.201	x²=0.524	x²=1.258	t=1.753	t=3.691	t=0.767	x²=0.632	t=0.428
P值		0.131	0.034	0.841	0.475	0.316	0.091	0.001	0.446	0.669	0.671

组别	例数	性别（男/女）	年龄（岁，±s）	BMI （±s）	手术侧（右/左）	手术方式（肩关节镜下修补+植骨内固定术/肩盂骨折切开复位内固定术）	手术间隔时间（月，±s）	CSA （±s）	AI （±s）	肩胛盂倾向（下倾/上倾）	LAA （±s）
对照组	47	37/10	40.5±14.2	25.9±2.9	35/12	30/17	0.62±0.56	41.01±5.19	0.82±0.81	9/38	68.11±7.50
骨关节炎组	11	6/5	52.1±14.9	25.7±2.9	7/4	5/6	0.40±0.32	34.63±5.03	0.80±0.09	1/10	69.24±9.42
检验值		x²=2.718	t=2.340	t=0.201	x²=0.524	x²=1.258	t=1.753	t=3.691	t=0.767	x²=0.632	t=0.428
P值		0.131	0.034	0.841	0.475	0.316	0.091	0.001	0.446	0.669	0.671

因素	单因素Logistic			多因素Logistic
因素	OR	95% CI	P值	OR	95% CI	P值
性别	3.083	0.778-12.221	0.109
年龄	1.056	1.006-1.108	0.027	1.085	1.015-1.159	0.016
BMI	0.976	0.773-1.233	0.838
手术侧	0.600	0.149-2.415	0.472
手术方式	2.118	0.561-7.988	0.268
手术间隔时间	0.348	0.064-1.890	0.221
CSA	0.779	0.660-0.919	0.003	0.744	0.617-0.898	0.002
AI	0.046	0.001-113.395	0.440
肩胛盂倾向	2.368	0.268-20.957	0.438
LAA	1.019	0.937-1.108	0.665

因素	单因素Logistic			多因素Logistic
因素	OR	95% CI	P值	OR	95% CI	P值
性别	3.083	0.778-12.221	0.109
年龄	1.056	1.006-1.108	0.027	1.085	1.015-1.159	0.016
BMI	0.976	0.773-1.233	0.838
手术侧	0.600	0.149-2.415	0.472
手术方式	2.118	0.561-7.988	0.268
手术间隔时间	0.348	0.064-1.890	0.221
CSA	0.779	0.660-0.919	0.003	0.744	0.617-0.898	0.002
AI	0.046	0.001-113.395	0.440
肩胛盂倾向	2.368	0.268-20.957	0.438
LAA	1.019	0.937-1.108	0.665

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