Thacher Ryan R, Retzky Julia S, Dekhne Mihir S, Oquendo Yousi A, Greditzer Harry G
Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA.
Department of Radiology, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA.
Curr Rev Musculoskelet Med. 2023 Sep;16(9):419-431. doi: 10.1007/s12178-023-09852-0. Epub 2023 Jun 21.
The extent of glenohumeral bone loss seen in anterior shoulder dislocations plays a major role in guiding surgical management of these patients. The need for accurate and reliable preoperative assessment of bone loss on imaging studies is therefore of paramount importance to orthopedic surgeons. This article will focus on the tools that are available to clinicians for quantifying glenoid bone loss with a focus on emerging trends and research in order to describe current practices.
Recent evidence supports the use of 3D CT as the most optimal method for quantifying bone loss on the glenoid and humerus. New trends in the use of 3D and ZTE MRI represent exciting alternatives to CT imaging, although they are not widely used and require further investigation. Contemporary thinking surrounding the glenoid track concept and the symbiotic relationship between glenoid and humeral bone loss on shoulder stability has transformed our understanding of these lesions and has inspired a new focus of study for radiologists and orthopedist alike. Although a number of different advanced imaging modalities are utilized to detect and quantify glenohumeral bone loss in practice, the current literature supports 3D CT imaging to provide the most reliable and accurate assessments. The emergence of the glenoid track concept for glenoid and humeral head bone loss has inspired a new area of study for researchers that presents exciting opportunities for the development of a deeper understanding of glenohumeral instability in the future. Ultimately, however, the heterogeneity of literature, which speaks to the diverse practices that exist across the world, limits any firm conclusions from being drawn.
肩关节前脱位时出现的盂肱关节骨质流失程度在指导这些患者的手术治疗中起主要作用。因此，在影像学研究中对骨质流失进行准确可靠的术前评估对骨科医生至关重要。本文将重点介绍临床医生可用于量化肩胛盂骨质流失的工具，重点关注新趋势和研究，以描述当前的实践。
最近的证据支持使用三维计算机断层扫描（3D CT）作为量化肩胛盂和肱骨骨质流失的最佳方法。三维和零回波时间磁共振成像（3D和ZTE MRI）的新应用趋势是计算机断层扫描成像（CT成像）令人兴奋的替代方法，尽管它们尚未广泛使用且需要进一步研究。围绕肩胛盂轨迹概念以及肩胛盂与肱骨骨质流失对肩部稳定性的共生关系的当代思维已经改变了我们对这些损伤的理解，并激发了放射科医生和骨科医生新的研究重点。虽然在实践中使用了许多不同的先进成像方式来检测和量化盂肱关节骨质流失，但目前的文献支持3D CT成像能提供最可靠和准确的评估。肩胛盂和肱骨头骨质流失的肩胛盂轨迹概念的出现激发了研究人员的一个新研究领域，为未来更深入地理解盂肱关节不稳提供了令人兴奋的发展机会。然而，最终，文献的异质性反映了世界各地存在的不同实践，限制了得出任何确凿的结论。
