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J Shoulder Elbow Surg. 2016 Nov;25(11):e339-e347. doi: 10.1016/j.jse.2016.04.002. Epub 2016 Jun 6.

Stress radiography for clinical evaluation of anterior shoulder instability.

Author information

1
Global Center for Shoulder, Elbow & Sports, NEON Orthopaedic Clinic, Konkuk University Medical Center, College of Medicine, Konkuk University, Seoul, Republic of Korea.
2
Orthopedic Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea. Electronic address: neomed95@gmail.com.
3
Orthopedic Surgery, Konkuk University Medical Center, College of Medicine, Konkuk University, Seoul, Republic of Korea.
4
Institute of Statistics, Korea University, Seoul, Republic of Korea.
5
Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea.

Abstract

BACKGROUND:

The purpose of this study was to examine the validity of stress radiography using the Telos GA-IIE as a clinical methodology to evaluate shoulder instability.

METHODS:

On 36 anterior shoulder dislocators and 23 uninjured volunteers, 4 types of stress radiographs were captured while applying 15 daN of force anteriorly (AER0 and AER60) and posteriorly (PER0 and PER60) at 2 different positions: (1) 90° of abduction combined with 0° external rotation and (2) 90° of abduction combined with 60° external rotation. The results of the anterior drawer test and of the same test under anesthesia were correlated.

RESULTS:

AER0 and AER60 from the affected shoulder revealed significantly larger displacement than on the normal side (P < .05), and all 4 radiographs from the affected joints demonstrated significantly larger displacement (P < .05) than in the volunteers. Among the 4 types of radiographs, AER0 and AER60 showed significantly higher displacement in the patients (P < .001), whereas there were no differences in the volunteers (P = .167). The results of the anterior drawer test positively correlated to AER60 (Pearson correlation coefficient [PCC] = 0.453; P = .005) and AER0 (PCC = 0.529; P = .001), and those of examination under anesthesia weakly correlated to AER60 (PCC = 0.287; P = .264) but highly correlated to AER0 (PCC = 0.695; P = .002).

CONCLUSION:

Stress radiographs on the affected shoulder frequently correlated with physical examinations, and the displacement of >3 mm on AER0 suggests anterior instability.

KEYWORDS:

Shoulder; Telos GA-IIE; instability; shoulder positioning device; stress radiography; validity

PMID:
27282732
DOI:
10.1016/j.jse.2016.04.002
[Indexed for MEDLINE]

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