Aims The prevalence of osteoarthritis (OA) associated with instability of the shoulder ranges between 4% and 60%. Articular cartilage is, however, routinely assessed in these patients using radiographs or scans (2D or 3D), with little opportunity to record early signs of cartilage damage. The aim of this study was to assess the prevalence and localization of chondral lesions and synovial damage in patients undergoing arthroscopic surgery for instablility of the shoulder, in order to classify them and to identify risk factors for the development of glenohumeral OA. Methods A total of 140 shoulders in 140 patients with a mean age of 28.5 years (15 to 55), who underwent arthroscopic treatment for recurrent glenohumeral instability, were included. The prevalence and distribution of chondral lesions and synovial damage were analyzed and graded into stages according to the division of the humeral head and glenoid into quadrants. The following factors that might affect the prevalence and severity of chondral damage were recorded: sex, dominance, age, age at the time of the first dislocation, number of dislocations, time between the first dislocation and surgery, preoperative sporting activity, Beighton score, type of instability, and joint laxity. Results A total of 133 patients (95%) had synovial or chondral lesions. At the time of surgery, shoulders were graded as having mild, moderate, and severe OA in 55 (39.2%), 72 (51.4%), and six (4.2%) patients, respectively. A Hill-Sachs lesion and fibrillation affecting the anteroinferior glenoid cartilage were the most common findings. There was a significant positive correlation between the the severity of the development of glenohumeral OA and the patient's age, their age at the time of the first dislocation, and the number of dislocations (p = 0.004, p = 0.011, and p = 0.031, respectively). Conclusion Synovial inflammation and chondral damage associated with instability of the shoulder are more prevalent than previously reported. The classification using quadrants gives surgeons more information about the chondral damage, and could explain the pattern of development of glenohumeral OA after stabilization of the shoulder. As the number of dislocations showed a positive correlation with the development of OA, this might be an argument for early stabilization.

中文翻译：

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使用关节镜检查与盂肱关节不稳定相关的关节病变的特征。


目的 与肩关节不稳定相关的骨关节炎 （OA） 的患病率在 4% 至 60% 之间。然而，这些患者的关节软骨常规使用 X 光片或扫描（2D 或 3D）进行评估，几乎没有机会记录软骨损伤的早期迹象。本研究的目的是评估因肩关节不稳而接受关节镜手术的患者软骨病变和滑膜损伤的患病率和定位，以便对其进行分类并确定盂肱骨 OA 发展的危险因素。方法 共纳入 140 例患者 140 个肩膀，平均年龄为 28.5 岁 （15 至 55 岁），这些患者因复发性盂肱关节不稳定而接受了关节镜治疗。分析软骨病变和滑膜损伤的患病率和分布，并根据肱骨头和关节盂的划分分为几个阶段。记录以下可能影响软骨损伤患病率和严重程度的因素： 性别、优势、年龄、第一次脱位时的年龄、脱位次数、第一次脱位与手术之间的时间、术前体育活动、Beighton 评分、不稳定类型和关节松弛。结果 共有 133 例患者 （95%） 有滑膜或软骨病变。手术时，肩部分别分为轻度、中度和重度 OA 55 例 （39.2%） 、 72 例 （51.4%） 和 6 例 （4.2%） 患者。A Hill-Sachs 病变和影响前下关节盂软骨的颤动是最常见的发现。 盂肱骨 OA 发展的严重程度与患者的年龄、第一次脱位时的年龄以及脱位的数量之间存在显着的正相关 （分别为 p = 0.004、p = 0.011 和 p = 0.031）。结论 与肩关节不稳定相关的滑膜炎症和软骨损伤比以前报道的更普遍。使用象限的分类为外科医生提供了更多关于软骨损伤的信息，并且可以解释肩部稳定后盂肱骨 OA 的发展模式。由于脱位的数量与 OA 的发生呈正相关，这可能是早期稳定的一个论点。