A reflective career narrative by Eiji Itoi tracing three research programs driven by clinical 'why' questions. Each program — on LHB tendon function, immobilization position after dislocation, and quantitative glenoid bone loss thresholds — produced findings that directly changed shoulder surgery practice.
Two numbers from this paper's cadaveric work are the operative thresholds you will use throughout your career: ≥21% of glenoid length for anteroinferior defects and ≥25% of glenoid width for anterior defects.
When you identify glenoid bone loss on CT in a patient with recurrent anterior instability, your job is not to eyeball whether it 'looks like one-third' — that standard is qualitatively defined and anatomically unmeasurable. Quantify it against glenoid dimensions and apply these thresholds to decide whether Bankart repair alone is sufficient.
For acute first-time dislocations in young patients, the external rotation immobilization data matters: a 36% relative risk reduction in recurrence is clinically meaningful, and abduction further improves Bankart lesion apposition during healing.
The on-track/off-track framework, which grew directly from this work, is now the standard approach for evaluating bipolar bone loss. You must assess the Hill-Sachs lesion and glenoid defect together, never in isolation.
A reflective career narrative by Eiji Itoi tracing three research programs driven by clinical 'why' questions. Each program — on LHB tendon function, immobilization position after dislocation, and quantitative glenoid bone loss thresholds — produced findings that directly changed shoulder surgery practice.
Two numbers from this paper's cadaveric work are the operative thresholds you will use throughout your career: ≥21% of glenoid length for anteroinferior defects and ≥25% of glenoid width for anterior defects.
When you identify glenoid bone loss on CT in a patient with recurrent anterior instability, your job is not to eyeball whether it 'looks like one-third' — that standard is qualitatively defined and anatomically unmeasurable. Quantify it against glenoid dimensions and apply these thresholds to decide whether Bankart repair alone is sufficient.
For acute first-time dislocations in young patients, the external rotation immobilization data matters: a 36% relative risk reduction in recurrence is clinically meaningful, and abduction further improves Bankart lesion apposition during healing.
The on-track/off-track framework, which grew directly from this work, is now the standard approach for evaluating bipolar bone loss. You must assess the Hill-Sachs lesion and glenoid defect together, never in isolation.