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采用 Bernageau 侧位像评估慢性前肩不稳定患者肩盂骨丢失的可靠性和有效性。

Reliability and validity assessment of a glenoid bone loss measurement using the Bernageau profile view in chronic anterior shoulder instability.

机构信息

Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, Boulogne-Billancourt, France.

出版信息

J Shoulder Elbow Surg. 2013 Sep;22(9):1193-8. doi: 10.1016/j.jse.2012.12.032. Epub 2013 Mar 6.

Abstract

BACKGROUND

One of the identified risk factors for anterior shoulder instability is bone loss on the anterior-inferior glenoid rim. The aim of our study was to assess intraobserver and interobserver reproducibility of the Bernageau view to estimate glenoid bone loss and validate this radiographic method with computed tomography (CT) scan. The second objective was to find correlation between Bernageau and arthroscopic bone loss measurements.

MATERIALS AND METHODS

Twenty patients were included retrospectively. Two independent observers evaluated glenoid bone loss with the ratio between glenoid joint surface diameters of the pathologic and healthy shoulders on Bernageau views. Results were compared with CT (gold standard) and arthroscopic measurements. Validity and reliability of Bernageau measurement were assessed with Spearman correlation coefficients (r) and intraclass correlation coefficients (ρ).

RESULTS

The interobserver and intraobserver reliability and the validity of Bernageau measurement compared with the reference test, the CT scan, were all excellent, with a Spearman ρ between 0.56 (P = .0002) and 0.95 (P < .00001) and an intraclass correlation coefficient between 0.82 (P = .0007) and 0.97 (P < .10(-5)). There was no correlation with arthroscopic evaluation.

CONCLUSION

The glenoid bone defect measurement on the Bernageau profile view is a valid and reliable method. Furthermore, it is easy to use in current clinical practice. Surgeons can therefore consider it as a tool for preoperative planning, and its use could decrease CT scan indications.

摘要

背景

前肩不稳定的一个已确定的危险因素是肩胛盂前缘下骨缺失。我们研究的目的是评估 Bernageau 视图评估肩胛盂骨缺失的观察者内和观察者间的可重复性,并通过 CT 扫描验证这种放射学方法。第二个目的是找到 Bernageau 视图和关节镜下骨缺失测量之间的相关性。

材料和方法

回顾性纳入 20 例患者。两名独立观察者使用 Bernageau 视图测量病变侧和健侧肩胛盂关节面直径的比值来评估肩胛盂骨缺失。结果与 CT(金标准)和关节镜测量进行比较。使用 Spearman 相关系数(r)和组内相关系数(ρ)评估 Bernageau 测量的有效性和可靠性。

结果

观察者间和观察者内的可靠性以及 Bernageau 测量与参考测试(CT 扫描)的有效性均非常好,Spearman ρ 值在 0.56(P=0.0002)至 0.95(P<0.00001)之间,组内相关系数在 0.82(P=0.0007)至 0.97(P<0.10(-5))之间。与关节镜评估无相关性。

结论

在 Bernageau 侧位像上测量肩胛盂骨缺损是一种有效且可靠的方法。此外,它在当前的临床实践中易于使用。因此,外科医生可以将其视为术前规划的工具,并且可以减少 CT 扫描的适应证。

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