3-D CT is the Most Reliable Imaging Modality When Quantifying Glenoid Bone Loss
- 1 April 2013
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 471 (4), 1251-1256
- https://doi.org/10.1007/s11999-012-2607-x
Abstract
Posttraumatic anterior shoulder instability is associated with anterior glenoid bone loss, contributing to recurrence. Accurate preoperative quantification of bone loss is paramount to avoid failure of a soft tissue stabilization procedure as bone reconstruction is recommended for glenoid defects greater than 20% to 27%. We determined whether radiography, MRI, or CT was most reliable to quantify glenoid bone loss in recurrent anterior shoulder instability. Seven intact fresh-frozen human cadaveric shoulders were imaged with radiography, MRI, CT, and three-dimensional (3-D) CT. Three sequential anterior glenoid defects then were created, measured, and the shoulders reimaged after each defect. Defect sizes were less than 12%, 12% to 25%, and 25% to 40%. The gold standard measurement was determined by comparing measurements taken on the cadaver by two surgeons using digital calipers with the measurements determined by using electronic digital calipers on the 3-D CT. This measurement was used for comparison of all estimations by the evaluators. Twelve independent blinded evaluators reviewed the 112 image sets and estimated the percent of glenoid bone loss. Images were scrambled and rereviewed by the same observers 2 months later to determine intraobserver reliability. We determined reliability with kappa values. Kappa values between predicted bone loss versus true loss (determined by our gold standard measurements) across all 12 raters for each modality were: 3-D CT, 0.50; CT, 0.40; MRI, 0.27; and radiographs, 0.15. Interobserver agreement (kappa) values were: 3-D CT, 0.54; CT, 0.47; MRI, 0.31; and radiographs, 0.15. The intraobserver agreement (kappa) values were: 3-D CT, 0.59; CT, 0.64; MRI, 0.51; and radiographs, 0.45. Three-dimensional CT was the most reliable imaging modality for predicting glenoid bone loss. Regular CT was the second most reliable and reproducible modality.Keywords
This publication has 23 references indexed in Scilit:
- Quantification of a glenoid defect with three-dimensional computed tomography and magnetic resonance imaging: A cadaveric studyJournal of Shoulder and Elbow Surgery, 2007
- Results of Modified Latarjet Reconstruction in Patients With Anteroinferior Instability and Significant Bone LossArthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
- Risk Factors for Recurrence of Shoulder Instability After Arthroscopic Bankart RepairThe Journal of Bone & Joint Surgery, 2006
- Location of the Glenoid Defect in Shoulders with Recurrent Anterior DislocationThe American Journal of Sports Medicine, 2005
- Management of Bone Loss Associated with Recurrent Anterior Glenohumeral InstabilityThe American Journal of Sports Medicine, 2005
- Reasons for failure after surgical repair of anterior shoulder instabilityJournal of Shoulder and Elbow Surgery, 2004
- Radiographic analysis of bone defects in chronic anterior shoulder instabilityArthroscopy: The Journal of Arthroscopic & Related Surgery, 2003
- GLENOID RIM MORPHOLOGY IN RECURRENT ANTERIOR GLENOHUMERAL INSTABILITYPublished by Ovid Technologies (Wolters Kluwer Health) ,2003
- Glenoid Rim Lesions Associated with Recurrent Anterior Dislocation of the ShoulderThe American Journal of Sports Medicine, 1998
- Instability of the shoulder: complex problems and failed repairs: Part I. Relevant biomechanics, multidirectional instability, and severe glenoid loss.1998