Cerciello S, Morris B J, Visonà E, Corona K, Edwards T B, Maffulli N, Walch G
Casa di cura Villa Betania, via Piccolomini 27, Rome, Italy.
Marrelli Hospital, via Gioacchino da Fiore 0962, Crotone, Italy.
Arch Orthop Trauma Surg. 2017 Jul;137(7):919-923. doi: 10.1007/s00402-017-2708-9. Epub 2017 May 9.
Symptomatic glenoid erosion is one of the most common causes of functional impairment after shoulder hemiarthroplasty. A decrease in the critical shoulder angle (CSA) has been associated with the development of shoulder arthritis. The inter-observer reliability of the CSA and the relationship between CSA and symptomatic glenoid erosion after shoulder hemiarthroplasty were investigated.
Twenty-eight patients with symptomatic glenoid erosion after anatomic hemiarthroplasty were compared to a control group of 30 patients with no signs of symptomatic glenoid erosion. The CSA was measured by two blinded shoulder surgeons at a mean follow-up of 105.2 and 54.7 months, respectively. The inter-observer reliability was calculated.
The mean CSA in the control group in neutral, internal, and external rotations was 34°, 33°, and 33°, respectively. The corresponding values in the study group were 33°, 33°, and 33° (<0.01). The interclass correlation coefficient between the two examiners was 0.917 (P < 0.01), 0.924 (P < 0.01), and 0.948 (P < 0.01), respectively. The Mann-Whitney test between the control group and the study group were, respectively, 0.907, 0.932, and 0.602.
There were no significant differences of CSA values between the two groups. Good inter-observer reliability was found for the CSA method.
症状性关节盂侵蚀是半肩关节置换术后功能障碍最常见的原因之一。临界肩角（CSA）减小与肩关节关节炎的发生有关。研究了CSA的观察者间可靠性以及半肩关节置换术后CSA与症状性关节盂侵蚀之间的关系。
将28例解剖型半肩关节置换术后出现症状性关节盂侵蚀的患者与30例无症状性关节盂侵蚀迹象的对照组患者进行比较。由两名不知情的肩关节外科医生分别在平均随访105.2个月和54.7个月时测量CSA。计算观察者间可靠性。
对照组中立位、内旋和外旋时的平均CSA分别为34°、33°和33°。研究组的相应值分别为33°、33°和33°（P<0.01）。两位检查者之间的组内相关系数分别为0.917（P<0.01）、0.924（P<0.01）和0.948（P<0.01）。对照组与研究组之间的曼-惠特尼检验分别为0.907、0.932和0.602。
两组间CSA值无显著差异。发现CSA测量方法具有良好的观察者间可靠性。
