Parnes Nata, Klahs Kyle J, Sandler Alexis B, Wynkoop Emily I, Goldman Adam, Fishbeck Keith, Rolf Robert H, Scanaliato John P
Department of Orthopaedic Surgery and Rehabilitation, Carthage Area Hospital, Carthage, New York, U.S.A.
Department of Orthopaedic Surgery and Rehabilitation, Claxton Hepburn Medical Center, Ogdensburg, New York, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Feb 5;6(2):100889. doi: 10.1016/j.asmr.2024.100889. eCollection 2024 Apr.
To evaluate the reliability of the "perfect-circle" methodology for measurement of glenoid bone loss with magnetic resonance imaging (MRI) in patients with posterior glenohumeral instability.
A prospective chart review was performed on patients who underwent isolated arthroscopic posterior labral repairs in our institution's electronic medical records between January 1, 2021, and June 30, 2021. Inclusion criteria included isolated posterior shoulder instability with posterior labral repair and corroborated tears on MRI. A total of 9 raters, either sports or shoulder and elbow fellowship-trained orthopaedic surgeons, each evaluated the affected shoulder MRI scans twice, at over 2 weeks apart. Measurements followed the "perfect-circle" technique and included projected anterior-to-posterior (AP) glenoid diameter, amount of posterior bone loss, and percentage of posterior bone loss.
Ten consecutive patients between the ages of 17 and 46 years with diagnosed posterior glenohumeral instability were selected. The average age was 28 ± 10 years, and 60% of patients were male. The patient's dominant arm was affected in 40%, and 50% of cases involved the right shoulder. The average glenoid diameter was 29.62 ± 3.69 mm, and the average measured bone loss was 2.8 ± 1.74 mm. The average percent posterior glenoid bone loss was 9.41 ± 5.78%. The inter-rater reliability was poor for the AP diameter and for the posterior glenoid bone loss with intraclass correlation coefficients at 0.30 (0.12-0.62) and 0.22 (0.07-0.54) respectively. The intrarater reliability was poor for AP diameter and moderate for posterior glenoid bone loss, with intraclass correlation coefficients at 0.41 (0.22-0.57) and 0.50 (0.33-0.64), respectively.
Using the "perfect-circle" technique for evaluating posterior glenohumeral bone loss has poor-to-moderate inter- and intrarater reliability from MRI.
Level IV, prospective diagnostic study.
评估在患有后盂肱关节不稳的患者中，使用磁共振成像（MRI）的“完美圆圈”方法测量盂骨丢失的可靠性。
对2021年1月1日至2021年6月30日期间在本机构电子病历中接受单纯关节镜下后盂唇修复的患者进行前瞻性病历回顾。纳入标准包括单纯后肩部不稳并进行后盂唇修复且MRI证实有撕裂。共有9名评估者，均为运动医学或肩肘专科培训的骨科医生，每人对患侧肩部MRI扫描进行两次评估，间隔超过2周。测量采用“完美圆圈”技术，包括预计的盂前后径、后骨丢失量和后骨丢失百分比。
选择了10例年龄在17至46岁之间诊断为后盂肱关节不稳的连续患者。平均年龄为28±10岁，60%的患者为男性。40%的患者患侧为优势臂，50%的病例累及右肩。平均盂直径为29.62±3.69mm，平均测量骨丢失为2.8±1.74mm。后盂骨丢失的平均百分比为9.41±5.78%。评估者间信度对于前后径和后盂骨丢失较差，组内相关系数分别为0.30（0.12 - 0.62）和0.22（0.07 - 0.54）。评估者内信度对于前后径较差，对于后盂骨丢失为中等，组内相关系数分别为0.41（0.22 - 0.57）和0.50（0.33 - 0.64）。
使用“完美圆圈”技术评估后盂肱关节骨丢失，从MRI来看，评估者间和评估者内信度为差到中等。
IV级，前瞻性诊断研究。
