Li Menglong, Fan Mingrui, Zhang Yuchen, Shao Pu, Liu Tong, Zuo Jianlin
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, China.
Am J Sports Med. 2025 Jan;53(1):24-32. doi: 10.1177/03635465241294076.
Surgical planning for anterior shoulder instability (ASI) necessitates accurate measurements of glenoid bone defects, but current methods are either challenging or too complex for practical use. This underscores the need for a simplified, but precise, assessment technique for anterior glenoid bone defects.
To introduce a new measurement technique that requires only computed tomography (CT) of the affected shoulder joint and simultaneously simplifies the assessment of bone defects in the anterior glenoid.
Cohort study (diagnosis); Level of evidence, 3.
CT scans of the glenoid from 285 healthy participants and 43 patients with unilateral ASI were collected and reconstructed in 3 dimensions. Initially, we established the proportional relationship between the maximum height and width in the superior-inferior and anterior-posterior directions of the glenoid as well as the location of their intersection (point O) in healthy participants. Subsequently, glenoid bone defects in patients with ASI were measured using the contralateral comparison method, the best-fit circle method, the CT-specific formula method, and our novel proportional method. We analyzed the differences in defect ratios and sizes as well as glenoid track calculations among the 4 methods.
The mean width-to-height ratio of the glenoid was determined to be 0.69 ± 0.04, allowing for the simplification of the calculation to width = 0.7 × height for clinical convenience. Point O was consistently located at the lower one-third of the glenoid height. There was no statistical significance noted in the measurements of bone defect size and bone defect ratio when comparing the novel proportional method, the contralateral comparison method, and the best-fit circle method; however, a significant increase in bone defect size and bone defect ratio was estimated with the CT-specific formula method (defect size: = 19.20, < .0001; defect ratio: = 15.99, < .0001).
We introduced a novel method for estimating the width of glenoid bone defects through the proportion of glenoid width to height, finding that 70% of the glenoid height at its lower one-third closely approximated its maximum width. This approach, requiring only CT data from the affected shoulder, simplified calculations and matched the accuracy of traditional methods. It offers potential clinical benefits in evaluating glenoid defects.
前肩不稳（ASI）的手术规划需要准确测量肩胛盂骨缺损，但目前的方法要么具有挑战性，要么过于复杂，不便于实际应用。这凸显了需要一种简化但精确的肩胛盂前侧骨缺损评估技术。
介绍一种新的测量技术，该技术仅需要对患侧肩关节进行计算机断层扫描（CT），同时简化肩胛盂前侧骨缺损的评估。
队列研究（诊断）；证据等级，3级。
收集285名健康参与者和43名单侧ASI患者的肩胛盂CT扫描数据，并进行三维重建。最初，我们确定了健康参与者肩胛盂在上下方向和前后方向上的最大高度与宽度之间的比例关系以及它们交点（点O）的位置。随后，使用对侧比较法、最佳拟合圆法、CT特定公式法和我们新颖的比例法测量ASI患者的肩胛盂骨缺损。我们分析了这4种方法在缺损率、尺寸以及肩胛盂轨迹计算方面的差异。
确定肩胛盂的平均宽高比为0.69±0.04，为临床方便起见，可简化计算为宽度=0.7×高度。点O始终位于肩胛盂高度的下三分之一处。在比较新颖的比例法、对侧比较法和最佳拟合圆法时，骨缺损尺寸和骨缺损率的测量结果无统计学意义；然而，CT特定公式法估计的骨缺损尺寸和骨缺损率显著增加（缺损尺寸： = 19.20， <.0001；缺损率： = 15.99， <.0001）。
我们引入了一种通过肩胛盂宽度与高度的比例来估计肩胛盂骨缺损宽度的新方法，发现肩胛盂下三分之一处其高度的70%与最大宽度非常接近。这种方法仅需要患侧肩部的CT数据，简化了计算并与传统方法的准确性相匹配。它在评估肩胛盂缺损方面具有潜在的临床益处。
