Ciais Grégoire, Klouche Shahnaz, Fournier Alexandre, Rousseau Benoit, Bauer Thomas, Hardy Philippe
Hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France.
Ambroise Paré Hospital, 9, Avenue Charles De Gaulle, 92104, Boulogne-Billancourt, France.
Eur J Orthop Surg Traumatol. 2016 Aug;26(6):581-6. doi: 10.1007/s00590-016-1815-6. Epub 2016 Jul 9.
The prevalence of combined humeral and glenoid defects varies between 79 and 84 % in case of chronic posttraumatic anterior shoulder instability. The main goal of this study was to evaluate the relationship between humeral and glenoid defects based on quantitative radiological criteria.
A retrospective study was performed between 2000 and 2011 including patients who underwent primary surgical shoulder stabilization for chronic posttraumatic anterior shoulder instability, with bone defects in both the glenoid and humerus and a healthy contralateral shoulder. The following measurements were taken: D/R ratio (Hill-Sachs lesion depth/humeral head radius) on an AP X-ray in internal rotation and the D1/D2 ratio [diameter of the involved glenoid articular surfaces (D1)/the healthy one (D2)] on a comparative Bernageau glenoid profile view. Measurements were taken by two observers. Correlations were determined by the Spearman correlation coefficients (r), Bland and Altman diagrams, and intra-class correlation coefficients (ICC). A sample size calculation was done.
Thirty patients were included, 25 men/5 women, mean age 29.8 ± 11.2 years. The mean D/R was 23 ± 12 % for observer 1 and 23 ± 10 % for observer 2. The mean D1/D2 was 95 ± 4 % for observer 1 and 94 ± 6 % for observer 2. No significant correlation was found between humeral and glenoid bone defects by observer 1 (r = 0.23, p = 0.22) or observer 2 (r = 0.05, p = 0.78). Agreement of the observers for the D/R ratio was excellent (ICC = 0.89 ± 0.04, p < 0.00001) and good for the D1/D2 ratio (ICC = 0.54 ± 0.14, p = 0.006).
Humeral and glenoid bone defects were not correlated. Inter-observer reliability was excellent for the D/R ratio and good for the D1/D2 ratio.
Nonconsecutive Patients, Diagnostic Study, Level III.
在慢性创伤性前肩关节不稳的情况下，肱骨和肩胛盂联合缺损的发生率在79%至84%之间。本研究的主要目的是基于定量放射学标准评估肱骨和肩胛盂缺损之间的关系。
对2000年至2011年期间进行的一项回顾性研究，纳入因慢性创伤性前肩关节不稳接受初次手术肩关节稳定术、肱骨和肩胛盂均有骨缺损且对侧肩部健康的患者。进行了以下测量：内旋位前后位X线片上的D/R比值（Hill-Sachs损伤深度/肱骨头半径），以及在比较性Bernageau肩胛盂轮廓视图上的D1/D2比值[患侧肩胛盂关节面直径（D1）/健侧（D2）]。由两名观察者进行测量。通过Spearman相关系数（r）、Bland和Altman图以及组内相关系数（ICC）确定相关性。进行了样本量计算。
纳入30例患者，25例男性/5例女性，平均年龄29.8±11.2岁。观察者1测得的平均D/R为23±12%，观察者2测得为23±10%。观察者1测得的平均D1/D2为95±4%，观察者2测得为94±6%。观察者1（r = 0.23，p = 0.22）或观察者2（r = 0.05，p = 0.78）均未发现肱骨和肩胛盂骨缺损之间存在显著相关性。观察者对D/R比值的一致性极佳（ICC = 0.89±0.04，p < 0.00001），对D1/D2比值的一致性良好（ICC = 0.54±0.14，p = 0.006）。
肱骨和肩胛盂骨缺损不相关。观察者间对D/R比值的可靠性极佳，对D1/D2比值的可靠性良好。
非连续患者，诊断性研究，III级。
