Karpinski Katrin, Akguen Doruk, Gebauer Henry, Paksoy Alp, Lupetti Mattia, Markova Viktoria, Zettinig Oliver, Moroder Philipp
Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
ImFusion, Munich, Germany.
Orthop J Sports Med. 2024 Feb 12;12(2):23259671231222938. doi: 10.1177/23259671231222938. eCollection 2024 Feb.
The presence of glenoid bone defects is indicative in the choice of treatment for patients with anterior shoulder instability. In contrast to traditional linear- and area-based measurements, techniques such as the consideration of glenoid concavity have been proposed and validated.
To compare the reliability of linear (1-dimensional [1D]), area (2-dimensional [2D]), and concavity (3-dimensional [3D]) measurements to quantify glenoid bone loss performed manually and to analyze how automated measurements affect reliability.
Cohort study (diagnosis); Level of evidence, 3.
Computed tomography images of 100 patients treated for anterior shoulder instability with differently sized glenoid defects were evaluated independently by 2 orthopaedic surgeons manually using conventional software (OsiriX; Pixmeo) as well as automatically with a dedicated prototype software program (ImFusion Suite; ImFusion). Parameters obtained included 1D (defect diameter, best-fit circle diameter), 2D (defect area, best-fit circle area), and 3D (bony shoulder stability ratio) measurements. Mean values and reliability as expressed by the intraclass correlation coefficient [ICC]) were compared between the manual and automated measurements.
When manually obtained, the measurements showed almost perfect agreement for 1D parameters (ICC = 0.83), substantial agreement for 2D parameters (ICC = 0.79), and moderate agreement for the 3D parameter (ICC = 0.48). When measurements were aided by automated software, the agreement between raters was almost perfect for all parameters (ICC = 0.90 for 1D, 2D, and 3D). There was a significant difference in mean values between manually versus automatically obtained measurements for 1D, 2D, and 3D parameters ( < .001 for all).
While more advanced measurement techniques that take glenoid concavity into account are more accurate in determining the biomechanical relevance of glenoid bone loss, our study showed that the reliability of manually performed, more complex measurements was moderate.
肩胛盂骨缺损的存在对前肩关节不稳患者的治疗选择具有指示作用。与传统的基于线性和面积的测量方法不同，诸如考虑肩胛盂凹陷等技术已被提出并得到验证。
比较手动进行的线性（一维[1D]）、面积（二维[2D]）和凹陷度（三维[3D]）测量以量化肩胛盂骨丢失的可靠性，并分析自动测量如何影响可靠性。
队列研究（诊断）；证据等级，3级。
100例因不同大小肩胛盂缺损接受前肩关节不稳治疗的患者的计算机断层扫描图像，由2名骨科医生分别使用传统软件（OsiriX；Pixmeo）手动评估，以及使用专用的原型软件程序（ImFusion Suite；ImFusion）自动评估。获得的参数包括1D（缺损直径、最佳拟合圆直径）、2D（缺损面积、最佳拟合圆面积）和3D（骨性肩关节稳定率）测量值。比较手动测量和自动测量之间的平均值和以组内相关系数[ICC]表示的可靠性。
手动测量时，1D参数显示几乎完全一致（ICC = 0.83），2D参数显示高度一致（ICC = 0.79），3D参数显示中度一致（ICC = 0.48）。当使用自动软件辅助测量时，评估者之间对所有参数的一致性几乎是完美的（1D、2D和3D的ICC均为0.90）。1D、2D和3D参数的手动测量值与自动测量值之间的平均值存在显著差异（所有P均<0.001）。
虽然考虑肩胛盂凹陷的更先进测量技术在确定肩胛盂骨丢失的生物力学相关性方面更准确，但我们的研究表明，手动进行的更复杂测量的可靠性为中度。
