Yang T-C, Chen K-H, Chiang E-R, Chang M-C, Ma H-L
Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Orthopaedic Department School of Medicine, National Yang-Ming University; Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Orthop Traumatol Surg Res. 2018 Oct;104(6):797-801. doi: 10.1016/j.otsr.2018.02.013. Epub 2018 Apr 11.
The glenoid track concept was used to confirm the engaging Hill-Sachs lesion (HSL) as a risk factor for recurrent instability following arthroscopic Bankart repair (ABR). However, the post-operative condition of soft tissue in vivo was not comparable to that designed in the intact condition in vitro in the original study of the glenoid track concept. Herein, the possibility of engagement may be underestimated.
A threshold of the Hill-Sachs interval to glenoid track width ratio (H/G ratio) that is related to recurrent instability after ABR could be found, in order to adjust the original glenoid track concept.
Patients who underwent ABR with minimum 24-months follow-up were reviewed retrospectively. The primary outcome was evaluated with the recurrent instability. The H/G ratio of individual patients was used to calculate the sensitivity, specificity, and a receiver operating characteristic (ROC) curve, which aimed to establish a H/G ratio threshold related to recurrent instability after ABR.
From June 2005 to December 2013, 160 patients with a mean age of 27.7years were enrolled. The mean follow-up period was 77.2 months. The ROC curve indicated that H/G ratio≥0.7 had the sensitivity and specificity of 0.74 and 0.71, respectively, in predicting recurrent instability. On univariate logistic regression analysis, the H/G ratio≥0.7 was a significant predictor of higher risk for recurrent instability (p<0.001).
H/G ratio seems to be a reliable parameter for predicting recurrent instability. H/G ratio≥0.7 may be considered as a positive predictor for recurrent instability after ABR.
Level IV: retrospective diagnostic study.
关节盂轨迹概念被用于确认关节镜下Bankart修复术（ABR）后复发性不稳定的危险因素——嵌顿性Hill-Sachs损伤（HSL）。然而，在关节盂轨迹概念的原始研究中，体内软组织的术后状况与体外完整状况下的设计情况不可比。在此情况下，嵌顿的可能性可能被低估。
为了调整原始的关节盂轨迹概念，可能会找到一个与ABR后复发性不稳定相关的Hill-Sachs间隙与关节盂轨迹宽度比（H/G比）阈值。
回顾性分析接受ABR且随访至少24个月的患者。主要结局通过复发性不稳定进行评估。使用个体患者的H/G比来计算敏感性、特异性和受试者工作特征（ROC）曲线，旨在建立一个与ABR后复发性不稳定相关的H/G比阈值。
2005年6月至2013年12月，纳入160例平均年龄27.7岁的患者。平均随访期为77.2个月。ROC曲线表明，H/G比≥0.7在预测复发性不稳定方面的敏感性和特异性分别为0.74和0.71。单因素逻辑回归分析显示，H/G比≥0.7是复发性不稳定高风险的显著预测因素（p<0.001）。
H/G比似乎是预测复发性不稳定的可靠参数。H/G比≥0.7可被视为ABR后复发性不稳定的阳性预测指标。
IV级：回顾性诊断研究。
