Research Impact Report - Project 546
Utilising novel MRI fingerprinting to determine If anterior shoulder dislocations cause early glenohumeral joint osteoarthritis and if progression is affected by treatment
Principal Investigator Salma Chaudhury
Stream Early-Career Fellowship
Duration 24 Months
Our study will use new MRI techniques to help patients and doctors know if:
1) one or more shoulder dislocations cause arthritis AND
2) surgery or physiotherapy can prevent arthritis from developing.
We want to keep our ageing population healthy and active. If our study shows dislocations don’t cause early arthritis, it suggests fewer patients should have surgery to avoid surgical complications and costs. However, if we show surgery does stop arthritis, maybe we should operate earlier on more shoulder dislocation patients to prevent arthritis, pain, disability and associated costs.
Arthritis is common and usually presents when it is irreversible and hard to treat. If our MRI scanning techniques can detect arthritis much earlier than we can now, it will help us judge if treatments such as surgery, physiotherapy or new drugs can help prevent or slow down arthritis in shoulders and other joints such as hips and knees.
Fundamental problem trying to address
Early arthritis (worn out joints) usually cannot be detected using plain X-rays or standard MRI scans. Arthritis can get worse without causing symptoms. Pain and loss of function may only present with advanced arthritis. Shoulder dislocations where the shoulder moves out of the joint, are common and mainly affect younger people. We see lots of these patients in clinics and need more evidence to help decide if, how and when to treat them.
It is important to find out if dislocations damage the cartilage lining the shoulder joint, causing younger patients get arthritis at an early age. We want to know if surgery or physiotherapy slows or prevents arthritis and if we should be offering earlier treatment. There are currently no treatments which stop advanced arthritis. The main treatment is shoulder replacements which our research should help avoid or delay as they are expensive and younger patients have worse outcomes.
A UK study reported 4% of men and 1.6% of women dislocated their shoulders. ASD was most common in 16-20 year-old men, affecting 8.1%, and women aged 61-70 years, affecting 2.9%. Overall, ASD happened in 4.9% of 16-20 year-olds, 3.9% of 21-30 year-olds, 2.4% of 31-40 year-olds, 2% of 41-60 year-olds and 2.8% of 61-70 year-olds) . Our study aims to include females over 50 years who are at higher risk of ASD but usually aren’t included in shoulder dislocation studies. In Edinburgh, 60% of 15–35 year-olds who played sports re-dislocated after 13.3 months .
In Sweden, 1.7% of 18–70 year-olds had shoulder dislocations , while two-thirds of patients under 40 with dislocations developed arthritis within 25 years . More Americans dislocated their shoulder (2.4%) . Canada has a similar dislocation rate of 2.3%, which was highest at 9.8% for 16-20 year-old men .
Aims & Objectives
Team members & other funders
Niel Kang, and Lee Van Rensburg, shoulder and elbow consultants, Addenbrooke’s.