反復性肩関節前方脱臼に対する各種関節窩骨欠損計測法の特徴と信頼性

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Background: Glenoid bony defect is known as a risk factor of postoperative recurrence of anterior glenohumeral instability. The purpose of this study was to measure the glenoid bony defect by three different methods with 3D-CT, and to evaluate the reliability of these methods. Methods: We used the en face 3D-CT views of the glenoid and measured bony defect of the glenoid by three methods in 20 patients with unilateral anterior shoulder instability. Method 1 (Fitting circle): a circle was fitted to the posterior-inferior glenoid contour and the bony defect was determined as the distance between the anterior edge of the glenoid rim and the anterior contour of the circle. Method 2 (Based on the glenoid long axis): The bony defect was determined by subtracting the distance between the glenoid long axis and posterior edge of the glenoid rim from the distance between the long axis and anterior edge of the glenoid rim. Method 3 (Comparing both shoulders): The bony defect was determined as the difference of antero-posterior widths of the glenoid comparing between both shoulders. Two observers calculated the ratios of bony defect twice by the three methods. Results: The ratios of bone defect of method 1 was significantly larger than those of the other methods (P<0.01). Intraclass correlation coefficients (ICC) revealed excellent intraobserver and interobserver reliability for method 3 (0.91-0.96), and moderate reliability for method 1 (0.43-0.67). Conclusion: The most reliable method for measurement of the glenoid bony defect was comparing antero-posterior widths between both shoulders.

反復性肩関節前方脱臼に対する各種関節窩骨欠損計測法の特徴と信頼性

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