Apivatgaroon Adinun, Tharakulphan Suthee, Kongmalai Pinkawas, Chernchujit Bancha
Orthopaedics Department, Faculty of Medicine, Thammasat University, Thailand.
Orthopaedics Department, Khon Kaen Hospital, Thailand.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2020 Feb 14;20:12-16. doi: 10.1016/j.asmart.2020.02.001. eCollection 2020 Apr.
A hooked acromion on an outlet view and a keeled acromion on Rockwood tilt radiographs are associated with rotator cuff tears. The identification of the acromial morphology may be helpful for acromioplasty planning with regarding the acromial types.
Descriptive Laboratory Study. Three-dimensional computed tomography scans models of 108 shoulders in 91 patients with; (1) Normal shoulders, (2) Shoulders with osteoarthritis, and (3) Irreparable rotator cuff tears; were created and adjusted manually to provide the proper supraspinatus outlet and Rockwood views. The acromial morphology/spurs were analyzed, classified and tested for reliability.
The intra-observer reliability of supraspinatus outlet view had a weak-to-strong agreement [0.828 (95%CI: 0.716-0.945, p-value<0.001), and 0.475 (95%CI: 0.288-0.672, p-value<0.001 from 2 evaluators]. The inter-rater of the supraspinatus outlet view has a minimal-to-moderate agreement [0.782 (95%CI: 0.662-0.907, p-value<0.001), and 0.344 (95%CI: 0.157-0.539, p-value<0.001) in the first and second readings]. The intra-observer reliability of the Rockwood view has a moderate-to-almost-perfect agreement [0.752 (95%CI: 0.652-0.860, p-value<0.001), and 0.903 (95%CI: 0.833-0.974, p-value<0.001) from 2 evaluators]. The inter-observer reliability of the Rockwood view has a moderate-to-strong agreement [0.854 (95%CI: 0.777-0.936, p-value<0.001), and 0.737 (95%CI: 0.634-0.847, p-value<0.001) in the first and second readings].
The classification of acromion morphology under Three-dimensional computed tomography in the supraspinatus outlet view has poor reliability. The Rockwood caudal tilt view model results in moderate-to-almost-perfect reliability that can be developed to the plain radiographic classification to determine the need for acromioplasty in rotator cuff surgery.
出口位X线片上的钩状肩峰和Rockwood倾斜位X线片上的龙骨状肩峰与肩袖撕裂相关。识别肩峰形态可能有助于根据肩峰类型进行肩峰成形术规划。
描述性实验室研究。创建了91例患者108个肩部的三维计算机断层扫描模型，这些患者包括：（1）正常肩部；（2）骨关节炎肩部；（3）不可修复的肩袖撕裂肩部；并手动调整以提供合适的冈上肌出口位和Rockwood位。对肩峰形态/骨赘进行分析、分类并测试其可靠性。
冈上肌出口位的观察者内可靠性具有弱到强的一致性[0.828（95%CI：0.716 - 0.945，p值<0.001），以及来自2名评估者的0.475（95%CI：0.288 - 0.672，p值<0.001）]。冈上肌出口位的观察者间一致性为最小到中等[第一次和第二次读数分别为0.782（95%CI：0.662 - 0.907，p值<0.001）和0.344（95%CI：0.157 - 0.539，p值<0.001）]。Rockwood位的观察者内可靠性具有中等至几乎完美的一致性[来自2名评估者的0.752（95%CI：0.652 - 0.860，p值<0.001）和0.903（95%CI：0.833 - 0.974，p值<0.001）]。Rockwood位的观察者间可靠性具有中等至强的一致性[第一次和第二次读数分别为0.854（95%CI：0.777 - 0.936，p值<0.001）和0.737（95%CI：0.634 - 0.847，p值<0.001）]。
三维计算机断层扫描下冈上肌出口位肩峰形态的分类可靠性较差。Rockwood尾侧倾斜位模型的结果具有中等至几乎完美的可靠性，可发展为普通X线片分类，以确定肩袖手术中肩峰成形术的必要性。
