Die SLAP-Läsion als Präarthrose?

Abstract

The development of glenohumeral osteoarthritis is sufficiently described after instability and rotator cuff pathologies. The purpose of this work was to evaluate a coherency between glenohumeral osteoarthritis and SLAP lesions by means of MR arthrography which has not been described up to now in the literature. 20 patients with a SLAP lesion type II were treated with arthroscopic SLAP repair. MR arthrography was performed after intra-articular administration of diluted gadolinium (after positive vote of the ethics committee) after a mean FU of 36 months (26 to 54 months). The MR arthrography data were analysed by 3 investigators (two radiologists, one orthopaedic surgeon) in consensus. Osteoarthritis was graded according to the modified Outerbridge classification for MRI. Besides image quality and artifacts, adhesions from the tendon to the bone and the rotator cuff were evaluated. Intraoperative documented findings were used for comparison. The clinical investigation encompassed Roweand Constant score, clinical investigation of instability and SLAP lesion (O'Brian test, SLAP apprehension test) as well as the subjective contentment. The statistical evaluation was performed with SAS reverse. In 12 of 20 cases an increase of glenohumeral osteoarthritis was seen, in 4 cases a circumscribed entire cartilage defect appeared in the MRI. Osteoarthritis did not correlate with the subjective and objectively collected clinical results or the aetiology of the SLAP lesion at the time of the re-examination. Results of the MR arthrography revealed that, in six cases, the biceps anchor did not show proper bony ingrowth. Nonetheless, these cases do not correlate with a poorer clinical result. Due to the small case number a correlation between SLAP lesion and osteoarthritis cannot be postulated statistically, however, the results still indicate a trend which should be pursued in the long-term course.