Reliability of humeral head measurements performed using two- and three-dimensional computed tomography in patients with shoulder instability

Stefaniak, Jakub; Kubicka, Anna Maria; Wawrzyniak, Anna; Romanowski, Leszek; Lubiatowski, Przemysław

doi:10.1007/s00264-020-04710-x

Cited by 15 publications

(13 citation statements)

References 38 publications

(44 reference statements)

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“…The three‐grade system described by Hovelius et al was the only well‐described classification system used in included studies and gives guidance on when a graft can be classified as adequately united with the glenoid [12]. The two‐dimensional nature of radiographs increases the risk of errors as a result of measurement errors or imperfections of the image [34]. Thus, CT may be a better fit for post‐operative evaluation.…”

Section: Discussionmentioning

confidence: 99%

High resorption rates following glenoid augmentation procedures do not seem to lead to higher recurrence rates or worse clinical outcomes: a systematic review and meta-analysis

Rutgers

Verweij

Schuit

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeBone augmentation techniques show a relatively high complication rate, which might be due to graft non‐union and resorption. It is unclear which augmentation techniques demonstrate the highest amount of non‐union and resorption and whether this leads to worse clinical or functional outcomes. Therefore, the aim of this review was (i) to compare non‐union and resorption rates between surgical approaches, procedures, graft types, donor sites and fixation methods regarding clinical and functional outcomes and (ii) determine whether high non‐union or resorption rates lead to less favorable clinical or functional outcomes. MethodsThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statements were followed. PubMed, EMBASE (Ovid) and Cochrane Library were searched on December 15th 2021 for studies examining bone graft non‐union or resorption using radiograph or CT following glenoid augmentation to treat anterior shoulder dislocation. ResultsThe search resulted in 103 inclusions, comprising 5,128 glenoid augmentations. When comparing pooled proportions of bony union, graft fracture rate, hardware failure rate, recurrence rate, return to sports and Rowe score, most results were similar between approaches, procedures, graft types, donor sites and fixation methods. High resorption rates were seen for allograft augmentation (74.3; 95% CI: 39.8–92.7) compared to autograft augmentation (15.5; 95% CI 10.1–23.2), but this was not associated with higher recurrence rates or worse clinical outcomes. Meta‐analyses (8 studies; 494 patients) demonstrated no difference in incomplete and complete non‐union rates between arthroscopic and open procedures; however, both analyses showed substantial heterogeneity. Higher partial resorption rates were observed on CT (48.0; 95% CI 43.3–52.7) compared to radiograph (14.1; 95% CI 10.9–18.1). Three studies comprising 267 shoulders demonstrated a higher rate of non‐union and recurrence in smokers, whereas one study comprising 38 shoulders did not. ConclusionNon‐union and resorption rates were similar among procedures, grafts and fixation methods. Higher resorption rates were observed in allografts, but this was not associated with higher recurrence rates or worse clinical outcomes. Pooling data demonstrated substantial heterogeneity and definitions varied among studies, warranting more standardized measuring. Level of evidenceIV.

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Section: Discussionmentioning

confidence: 99%

High resorption rates following glenoid augmentation procedures do not seem to lead to higher recurrence rates or worse clinical outcomes: a systematic review and meta-analysis

Rutgers

Verweij

Schuit

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…Inconvenience still exists in clinical practice because of the time-consuming measurements and needs for specialized software, 16,28,40 even if evaluating HSLs using an advanced 3D modeling method does yield a more accurate preoperative evaluation than does conventional 2D imaging. 16,20,44,48 It is relatively simple to measure the native glenoid depth in this condition and determine the HSL width, volume, and medialization.…”

Section: Discussionmentioning

confidence: 99%

Native Glenoid Depth and Hill-Sachs Lesion Morphology in Traumatic Anterior Shoulder Instability

Wu,

Liu,

et al. 2023

Am J Sports Med

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Background: Although Hill-Sachs lesions (HSLs) are assumed to be influenced by glenoid characteristics in the context of bipolar bone loss, little is known about how glenoid concavity influences HSL morphology. Purpose: To investigate the relationship between the native glenoid depth and HSL morphological characteristics. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Computed tomography images of bilateral shoulders from 151 consecutive patients with traumatic unilateral anterior shoulder instability were retrospectively reviewed. Patients were categorized into flat (<1 mm), moderate (1-2 mm), and deep (>2 mm) groups based on the native glenoid depth measured from the contralateral unaffected shoulder. The HSL morphological characteristics included size (depth, width, length, and volume), location (medial, superior, and inferior extent), and orientation (rim and center angle). The glenoid characteristics included diameter, depth, version, and bone loss. The patient, glenoid, and HSL morphological characteristics were compared among the 3 depth groups. Subsequently, the independent predictors of some critical HSL morphological characteristics were determined using multivariate stepwise regression. Results: After exclusion of 55 patients, a total of 96 patients were enrolled and classified into the flat group (n = 31), moderate group (n = 35), and deep group (n = 30). Compared with those in the flat group, patients in the deep group were more likely to have dislocation (38.7% vs 93.3%; P = .009) at the primary instability and had a significantly larger number of dislocations (1.1 ± 1.0 vs 2.2 ± 1.8; P = .010); moreover, patients in the deep group had significantly deeper, wider, larger volume, more medialized HSLs and higher incidences of off-track HSLs (all P≤ .025). No significant differences were detected among the 3 groups in HSL length, vertical position, and orientation (all P≥ .064). After adjustment for various radiological and patient factors in the multivariate regression model, native glenoid depth remained the strongest independent predictor for HSL depth (β = 0.346; P < .001), width (β = 0.262; P = .009), volume (β = 0.331; P = .001), and medialization (β = −0.297; P = .003). Conclusion: The current study sheds light on the association between native glenoid depth and the morphology of HSLs in traumatic anterior shoulder instability. Native glenoid depth was independently and positively associated with HSL depth, width, volume, and medialization. Patients with deeper native glenoids were more likely to have off-track HSLs and thus require more attention in the process of diagnosis and treatment.

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“…This study was guided by an earlier study on the reliability of glenoid bone defect measurements on 2D and 3D CT [22]. Accordingly, two models were applied to test intra-and inter-observer reliability.…”

Section: Statistical Analysesmentioning

confidence: 99%

Long-Term Comparison of Two- and Three-Dimensional Computed Tomography Analyses of Cranial Bone Defects in Severe Parietal Thinning

Pallua¹,

Pallua²,

Streif³

et al. 2023

Preprint

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Quantification of bone loss for follow-up comparisons has not been routinely performed in patients with parietal thinning so far. This study compares different methodological approaches including both 2- and 3-dimensional methods in computerized tomographies of a single patient. The 2-dimensional method provides accurate measurements of bone thickness, while the 3-dimensional method allows for a more comprehensive view of the bone's structure, including parameters like shape, size, and thickness. The techniques provided valuable data for the treating physician and suggest a possible effect of corticosteroids in this individual patient. The study concludes that 3-dimensional reconstruction of computerized tomographies with subsequent 2-dimensional analyses appears justified for routine radiological practice to increase clinical awareness of the size of the parietal bone defects and allow for quantification of bone loss during long-term follow-ups. Further validation of the proposed analytical approaches is warranted in larger studies to investigate patterns of bone thinning across the skull and changes in bone volumes over time, with specialized software to be approved for such analyses.

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Reliability of humeral head measurements performed using two- and three-dimensional computed tomography in patients with shoulder instability

Cited by 15 publications

References 38 publications

High resorption rates following glenoid augmentation procedures do not seem to lead to higher recurrence rates or worse clinical outcomes: a systematic review and meta-analysis

High resorption rates following glenoid augmentation procedures do not seem to lead to higher recurrence rates or worse clinical outcomes: a systematic review and meta-analysis

Native Glenoid Depth and Hill-Sachs Lesion Morphology in Traumatic Anterior Shoulder Instability

Long-Term Comparison of Two- and Three-Dimensional Computed Tomography Analyses of Cranial Bone Defects in Severe Parietal Thinning

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