Samim Mohammad, Virk Mandeep, Mai David, Munawar Kamran, Zuckerman Joseph, Gyftopoulos Soterios
Department of Radiology, Hospital of Joint Disease, 301 East 17th Street, Rm 600, New York, NY, 10003, USA.
Department of Orthopedic Surgery, Hospital of Joint Disease, 301 East 17th Street, New York, NY, 10003, USA.
Skeletal Radiol. 2019 Jun;48(6):907-914. doi: 10.1007/s00256-018-3095-1. Epub 2018 Oct 17.
A major factor that impacts the long-term outcome and complication rates of total shoulder arthroplasty is the preoperative posterior glenoid bone loss quantified by glenoid retroversion. The purpose of this study was to assess if glenoid retroversion varies significantly at different glenoid heights in Walch B2 and B3 glenoids.
Patients with B2 and B3 glenoid types were included following retrospective review of 386 consecutive CT shoulder studies performed for arthroplasty preoperative planning. True axial CT reconstructions were created using a validated technique. Two readers independently measured the glenoid retroversion angles according to the Friedman method using the "intermediate" glenoid at three glenoid heights: 75% (upper), 50% (equator), and 25% (lower). The variances between the three levels for a given patient were calculated.
Twenty-nine B2 and 8 B3 glenoid types were included. There was no significant difference in variance of glenoid version among the three levels in B2 or B3 groups. The mean variance in retroversion degree between equator-lower, upper-equator, and upper-lower glenoid was - 0.4, 0.3, and - 0.2 for B2; and - 0.2, 1.9, and 1.9 for B3 glenoid, respectively. The level of inter-reader agreement was fair to good for variance at equator-lower, and good to excellent for upper-equator and upper-lower glenoid.
Glenoid version can be accurately measured at any level between 25 and 75% of glenoid height for Walch B2 and B3. We recommend that the glenoid equator be used as the reference to assure consistent and reliable version measurements in this group of patients.
影响全肩关节置换术长期疗效和并发症发生率的一个主要因素是术前通过关节盂后倾量化的关节盂后缘骨质丢失。本研究的目的是评估在Walch B2和B3型关节盂中，不同关节盂高度处的关节盂后倾是否存在显著差异。
在对386例连续的用于关节置换术前规划的肩部CT研究进行回顾性分析后，纳入B2和B3型关节盂的患者。使用经过验证的技术创建真正的轴向CT重建图像。两名阅片者根据Friedman方法，在三个关节盂高度（75%（上部）、50%（赤道部）和25%（下部））处，使用“中间”关节盂独立测量关节盂后倾角度。计算给定患者三个水平之间的差异。
纳入29例B2型和8例B3型关节盂。B2组或B3组三个水平之间关节盂版本差异无统计学意义。B2型关节盂赤道部-下部、上部-赤道部和上部-下部之间后倾程度的平均差异分别为-0.4、0.3和-0.2；B3型关节盂分别为-0.2、1.9和1.9。阅片者之间在赤道部-下部差异方面的一致性为中等至良好，在上部-赤道部和上部-下部关节盂方面为良好至优秀。
对于Walch B2和B3型关节盂，在关节盂高度的25%至75%之间的任何水平都可以准确测量关节盂版本。我们建议将关节盂赤道部用作参考，以确保在这组患者中进行一致且可靠的版本测量。
