Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA.
J Shoulder Elbow Surg. 2010 Mar;19(2):166-71. doi: 10.1016/j.jse.2009.08.009. Epub 2009 Dec 2.
BACKGROUND/HYPOTHESIS: The arthritic glenoid is typically in retroversion and restoration to neutral version is recommended. While a method for measurement of glenoid version using axial computed tomography (CT) has been reported and has been widely accepted, its accuracy and reproducibility has not been established.
In 33 patients scheduled for shoulder arthroplasty, glenoid version and maximum wear of the glenoid articular surface were measured with respect to the scapular body axis on 2-dimensional- (2D) CT slices as well as on 3-dimensional- (3D) reconstructed models of the same CT slices.
Clinical CT scans were axially aligned with the patient's torso but were almost never perpendicular to the scapular body. The average absolute error in version measured on the 2D-CT slice passing through the tip of the coracoid was 5.1 degrees (range, 0 - 16 degrees , P < .001). On high-resolution 3D-CT reconstructions, the location of maximum wear was most commonly posterior and was missed on the clinical 2D-CT slices in 52% of cases.
Error in measuring version and depth of maximum wear can substantially affect the determination of the degree of correction necessary in arthritic glenoids. Accurately measuring glenoid version and locating the direction of maximum wear requires a full 3D-CT reconstruction and analysis.
背景/假设：关节炎性肩盂通常处于后旋位，建议恢复至中性位置。虽然已经报道了一种使用轴向计算机断层扫描（CT）测量肩盂位置的方法，并被广泛接受，但尚未确定其准确性和可重复性。
在 33 名计划接受肩部关节置换术的患者中，使用二维 CT 切片以及同一 CT 切片的三维重建模型，测量了肩盂位置相对于肩胛体轴的肩盂位置和肩盂关节面的最大磨损。
临床 CT 扫描与患者的躯干轴向对齐，但几乎从未与肩胛体垂直。通过喙突尖端的二维 CT 切片测量的位置平均绝对误差为 5.1 度（范围，0 - 16 度，P <.001）。在高分辨率的 3D-CT 重建中，最大磨损的位置最常见于后部，在 52%的情况下，临床二维 CT 切片会遗漏。
在测量位置和最大磨损深度时的误差会极大地影响确定关节炎性肩盂所需的矫正程度。准确测量肩盂位置和确定最大磨损方向需要进行完整的 3D-CT 重建和分析。
