Department of Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, UK.
Bone Joint J. 2022 Jan;104-B(1):12-18. doi: 10.1302/0301-620X.104B1.BJJ-2021-0751.R1.
The amount of glenoid bone loss is an important factor in deciding between soft-tissue and bony reconstruction when managing anterior shoulder instability. Accurate and reproducible measurement of glenoid bone loss is therefore vital in evaluation of shoulder instability and recommending specific treatment. The aim of this systematic review is to identify the range methods and measurement techniques employed in clinical studies treating glenoid bone loss.
A systematic review of the PubMed, MEDLINE, and Embase databases was undertaken to cover a ten-year period from February 2011 to February 2021. We identified clinical studies that incorporated bone loss assessment in the methodology as part of the decision-making in the management of patients with anterior shoulder instability. The Preferred Reporting Items for Systematic Reviews (PRISMA) were used.
A total of 5,430 articles were identified from the initial search, of which 82 studies met the final inclusion criteria. A variety of imaging methods were used: three studies did not specify which modality was used, and a further 13 used CT or MRI interchangeably. There was considerable heterogeneity among the studies that specified the technique used to quantify glenoid bone loss. A large proportion of the studies did not specify the technique used.
This systematic review has identified significant heterogeneity in both the imaging modality and method used to measure glenoid bone loss. The recommendation is that as a minimum for publication, authors should be required to reference the specific measurement technique used. Without this simple standardization, it is impossible to determine whether any published paper should influence clinical practice or should be dismissed. Cite this article: 2022;104-B(1):12-18.
在处理肩关节前向不稳定时，肩盂骨量丢失的程度是决定软组织重建还是骨重建的重要因素。因此，准确和可重复的肩盂骨量丢失测量对于评估肩关节不稳定和推荐特定治疗方法至关重要。本系统综述的目的是确定在治疗肩盂骨量丢失的临床研究中使用的范围、方法和测量技术。
对 PubMed、MEDLINE 和 Embase 数据库进行了系统综述，时间范围为 2011 年 2 月至 2021 年 2 月，共 10 年。我们确定了纳入研究的标准为：在治疗肩关节前向不稳定患者的管理决策中纳入骨丢失评估方法的临床研究。本研究采用了系统综述的 Preferred Reporting Items（PRISMA）。
最初搜索共确定了 5430 篇文章，最终有 82 项研究符合最终纳入标准。使用了多种影像学方法：有 3 项研究未明确说明使用了哪种模态，另有 13 项研究交替使用 CT 或 MRI。指定用于定量肩盂骨丢失的技术存在很大的异质性。很大一部分研究没有具体说明使用的技术。
本系统综述发现，在测量肩盂骨量丢失的影像学方式和方法上存在显著的异质性。建议至少在出版物中，作者应参考使用的特定测量技术。如果没有这种简单的标准化，就无法确定任何已发表的论文是否应影响临床实践或应被驳回。 引用本文：2022；104-B（1）：12-18。
