Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
Department of Orthopaedic Surgery, Iwaki City Medical Center, Iwaki, Japan.
J Shoulder Elbow Surg. 2020 Mar;29(3):502-507. doi: 10.1016/j.jse.2019.07.027. Epub 2019 Sep 26.
Several measurement techniques have been reported to quantify glenoid bone defect in patients with anterior shoulder instability. Among them, the method that uses a best-fit circle and another that uses the contralateral glenoid as a control are most commonly used. However, to our knowledge, no study has been reported that compared the reliability of these methods. The purpose of this study, therefore, was to determine which of these methods has higher reproducibility.
In this study, 3-dimensional computed tomography data from 94 patients (mean age 29 years) with unilateral anterior shoulder instability were used. Three examiners measured the glenoid bone defect of each patient 3 times using 2 techniques: the best-fit circle method and the contralateral comparison method. Intra- and interobserver reliabilities were measured using intraclass correlation coefficient (ICC).
The intraobserver reliability was found to be 0.91 for the best-fit circle method and 0.98 for the contralateral comparison method. The interobserver reliability was 0.77 for the best-fit circle method and 0.88 for the contralateral method. The percentage of glenoid defect was 11.5% when using the best-fit circle and 10.7% with the contralateral method.
The contralateral comparison method was more reliable than the best-fit circle method for quantifying the amount of glenoid bone loss.
有几种测量技术已被报道用于量化患有肩关节前不稳定的患者的肩胛盂骨缺损。其中，最常用的方法是使用最佳拟合圆的方法和使用对侧肩胛盂作为对照的方法。然而，据我们所知，尚无研究比较这些方法的可靠性。因此，本研究的目的是确定这些方法中哪一种具有更高的可重复性。
本研究使用了 94 例（平均年龄 29 岁）单侧肩关节前不稳定患者的三维 CT 数据。三名检查者使用两种技术（最佳拟合圆法和对侧比较法）对每位患者的肩胛盂骨缺损进行了 3 次测量。使用组内相关系数（ICC）测量了内和观察者之间的可靠性。
最佳拟合圆法的观察者内可靠性为 0.91，对侧比较法为 0.98。最佳拟合圆法的观察者间可靠性为 0.77，对侧方法为 0.88。使用最佳拟合圆法时，肩胛盂缺损百分比为 11.5%，而使用对侧方法时为 10.7%。
与最佳拟合圆法相比，对侧比较法在量化肩胛盂骨丢失量方面更可靠。
