Privitera David M, Siegel Elana J, Miller Lindsay R, Sinz Nathan J, Higgins Laurence D
Department of Orthopaedic Surgery, Rochester General Health System, Rochester, NY, USA.
Boston Shoulder Institute, Brigham and Women's Hospital, Boston, MA, USA.
J Shoulder Elbow Surg. 2016 Jul;25(7):1056-63. doi: 10.1016/j.jse.2015.11.013. Epub 2016 Mar 3.
Evidence suggests a relationship between glenoid retroversion and posterior instability, but no literature exists comparing glenoid version referencing the scapular body versus the endosteal vault. This study evaluated glenoid version and its relationship to unidirectional instability and labral tears.
Glenoid version in patients with unidirectional instability or labral tears was measured with magnetic resonance imaging by either the Friedman method or the Poon and Ting method. Analyses of variance followed by independent t tests were used to compare 3 groups: anterior instability or labral tears (anterior pathology group, n = 33); posterior instability or labral tears (posterior pathology group, n = 34); and stable controls (n = 30). The referencing error for 2-dimensional axial images was evaluated for variance by imaging facility. Interobserver and intraobserver reliability scores were calculated.
With the Friedman method, the posterior pathology group (-9°) was more retroverted than the control group (-4°) (P = .0005) and the anterior pathology group (-5°) (P = .0104) but there was no difference between the control group and anterior pathology group (P = .38). The referencing error in the sagittal plane averaged 23° and varied by facility (P = .0365). The coronal-plane error averaged 1° and did not vary by facility (P = .7180). Intraclass correlation coefficient scores showed good to excellent intrarater and inter-rater reliability.
The posterior pathology group had 5° more retroversion than controls using the Friedman method. Glenoid version using the Poon and Ting method or the Friedman method did not predict anterior instability or labral tears. Axial magnetic resonance images were constructed with a referencing error in the sagittal plane that varied by magnetic resonance imaging facility and has implications for improving 2-dimensional axial imaging protocols.
有证据表明肩胛盂后倾与后方不稳定之间存在关联，但尚无文献比较以肩胛体为参照与以内骨皮质腔为参照的肩胛盂倾斜度。本研究评估了肩胛盂倾斜度及其与单向不稳定和盂唇撕裂的关系。
采用磁共振成像，通过弗里德曼方法或潘氏和丁氏方法测量单向不稳定或盂唇撕裂患者的肩胛盂倾斜度。采用方差分析及独立t检验对三组进行比较：前方不稳定或盂唇撕裂（前方病变组，n = 33）；后方不稳定或盂唇撕裂（后方病变组，n = 34）；以及稳定对照组（n = 30）。通过成像设备评估二维轴向图像的参照误差的方差。计算观察者间和观察者内可靠性评分。
采用弗里德曼方法时，后方病变组（-9°）比对照组（-4°）（P = 0.0005）和前方病变组（-5°）（P = 0.0104）后倾更明显，但对照组和前方病变组之间无差异（P = 0.38）。矢状面的参照误差平均为23°，且因设备而异（P = 0.0365）。冠状面误差平均为1°，不因设备而异（P = 0.7180）。组内相关系数评分显示观察者内和观察者间可靠性良好至优秀。
采用弗里德曼方法时，后方病变组比对照组后倾多5°。采用潘氏和丁氏方法或弗里德曼方法测得的肩胛盂倾斜度不能预测前方不稳定或盂唇撕裂。轴向磁共振图像在矢状面存在因磁共振成像设备而异的参照误差，这对改进二维轴向成像方案具有启示意义。
