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International Orthopaedics
Published in: International Orthopaedics 10/2020

Open Access 01-10-2020 | Computed Tomography | Original Paper

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

Authors: Jakub Stefaniak, A. M. Kubicka, A. Wawrzyniak, L. Romanowski, P. Lubiatowski

Published in: International Orthopaedics | Issue 10/2020

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Abstract

Purpose

The aim of the study was to compare two measurement methods of humeral head defects in patients with shoulder instability. Intra- and inter-observer reliability of humeral head parameters were performed with the use of 2D and 3D computed tomography.

Methods

The study group was composed of one hundred humeral heads measured with the use of preoperative 2D and 3D computed tomography by three independent observers (two experienced and one inexperienced). All observers repeated measurements after 1 week. The intra-class correlation coefficient (ICC) and the minimal detectable change with 95% confidence (MDC95%) were used for statistical analysis of diagnostic agreement.

Results

For 3D inter-observer reliability, ICC values were “excellent” for all parameters and MDC95% values were “excellent” or “reasonable.” All intra-observer ICC and MDC95% values for 3D were “excellent” for experienced and inexperienced observers. For 2D-CT, ICC values were usually “good” or “moderate” with MDC95% values higher than 10 or 30%.

Conclusions

Three-dimensional CT measurements are more reliable than 2D for humeral head and Hill-Sachs lesion assessment. This study showed that 2D measurements, even performed by experienced observers (orthopaedic surgeons), are burdened with errors. The 3D reconstruction decreased the risk of error by eliminating inaccuracy in setting the plane of the measurements.
Literature
1.
Zacchilli MA, Owens BD (2010) Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Jt Surg Ser A 92(3):542–549CrossRef
2.
McLaughlin HL, Cavallaro WU (1950) Primary anterior dislocation of the shoulder. Am J Surg 80(6):615–621CrossRef
3.
Yamamoto N et al (2009) Effect of an anterior glenoid defect on anterior shoulder stability: a cadaveric study. Am J Sports Med 37(5):949–954CrossRef
4.
Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 16(7):677–694CrossRef
5.
Itoi E, Lee SB, Berglund LJ, Berge LL, An KN (2000) The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 82(1):35–46CrossRef
6.
Yamamoto N, Itoi E (2015) Osseous defects seen in patients with anterior shoulder instability. Clin Orthop Surg 7(4):425–429CrossRef
7.
Yamamoto N et al (2007) Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track. J Shoulder Elb Surg 16(5):649–656CrossRef
8.
Balg F, Boileau P (2007) The instability severity index score: a simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Jt Surg Ser B 89(11):1470–1477CrossRef
9.
Tauber M, Resch H, Forstner R, Raffl M, Schauer J (2004) Reasons for failure after surgical repair of anterior shoulder instability. J Shoulder Elb Surg 13(3):279–285CrossRef
10.
Fujii Y, Yoneda M, Wakitani S, Hayashida K (2006) Histologic analysis of bony Bankart lesions in recurrent anterior instability of the shoulder. J Shoulder Elb Surg 15(2):218–223CrossRef
11.
Bouliane MJ et al (2013) The intra- and inter-rater reliability of plain radiographs for Hill-Sachs and bony glenoid lesions: evaluation of the radiographic portion of the instability severity index score. Shoulder Elb 5(1):33–38CrossRef
12.
Rouleau DM, Hébert-Davies J, Djahangiri A, Godbout V, Pelet S, Balg F (2013) Validation of the instability shoulder index score in a multicenter reliability study in 114 consecutive cases. Am J Sports Med 41(2):278–282CrossRef
13.
Hirschmann MT, Konala P, Amsler F, Iranpour F, Friederich NF, Cobb JP (2011) The position and orientation of total knee replacement components. J Bone Joint Surg Br 93-B(5):629–633CrossRef
14.
Kubicka AM et al (2016) Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability. Int Orthop 40(12):2581–2588CrossRef
15.
Saito H, Itoi E, Minagawa H, Yamamoto N, Tuoheti Y, Seki N (2009) Location of the Hill-Sachs lesion in shoulders with recurrent anterior dislocation. Arch Orthop Trauma Surg 129(10):1327–1334CrossRef
16.
Cho SH, Cho NS, Rhee YG (2011) Preoperative analysis of the hill-sachs lesion in anterior shoulder instability: how to predict engagement of the lesion. Am J Sports Med 39(11):2389–2395CrossRef
17.
Kodali P, Jones MH, Polster J, Miniaci A, Fening SD (2011) Accuracy of measurement of Hill-Sachs lesions with computed tomography. J Shoulder Elb Surg 20(8):1328–1334CrossRef
18.
Pearl ML, Kurutz S, Postachini R (2009) Geometric variables in anatomic replacement of the proximal humerus: how much prosthetic geometry is necessary? J Shoulder Elb Surg 18(3):366–370CrossRef
19.
Pearl ML (2005) Proximal humeral anatomy in shoulder arthroplasty: implications for prosthetic design and surgical technique. J Shoulder Elb Surg 14(1 SUPPL):S99–S104CrossRef
20.
Arifin WN (2018) A web-based sample size calculator for reliability studies. Educ Med J 10(3):67–76CrossRef
21.
Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15(2):155–163CrossRef
22.
Portney L, Watkins M (2000) Foundations of clinical research: applications to practice. Prentice Hail, New Jersey
23.
Huang S-L, Hsieh C-L, Wu R-M, Tai C-H, Lin C-H, Lu W-S (2011) Minimal detectable change of the timed ‘up & go’ test and the dynamic gait index in people with Parkinson disease. Phys Ther 91(1):114–121CrossRef
24.
Malgaigne J (1855) Traité des fractures et des luxations. Paris JB Baillière
25.
Hill H, Sachs M (1940) The grooved defect of humeral head: a frequently unrecognized complication of dislocations of the shoulder joint. Radiology 35(13):690–700CrossRef
26.
Spatschil A et al (2006) Posttraumatic anterior-inferior instability of the shoulder: arthroscopic findings and clinical correlations. Arch Orthop Trauma Surg 126(4):217–222CrossRef
27.
Yiannakopoulos CK, Mataragas E, Antonogiannakis E (2007) A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthrosc J Arthrosc Relat Surg 23(9):985–990CrossRef
28.
Calandra JJ, Baker CL, Uribe J (1989) The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations. Arthrosc J Arthrosc Relat Surg 5(4):254–257CrossRef
29.
Churchill RS, Brems JJ, Kotschi H (2001) Glenoid size, inclination, and version: An anatomic study. J Shoulder Elb Surg 10(4):327–332CrossRef
30.
Beuckelaers E, Jacxsens M, Van Tongel A, De Wilde LF (2014) Three-dimensional computed tomography scan evaluation of the pattern of erosion in type B glenoids. J Shoulder Elb Surg 23(1):109–116CrossRef
31.
Maio M, Sarmento M, Moura N. Shoulder & Elbow How to measure a Hill – Sachs lesion : a systematic review. vol. 4, no. April, 2019
32.
Ho A, Kurdziel MD, Koueiter DM, Wiater JM (2018) Three-dimensional computed tomography measurement accuracy of varying Hill-Sachs lesion size. J Shoulder Elb Surg 27(2):350–356
33.
Kaup M et al (2016) Dual-energy CT-based display of bone marrow edema in osteoporotic vertebral compression fractures: impact on diagnostic accuracy of radiologists with varying levels of experience in correlation to MR imaging. Radiology 280(2):510–519CrossRef
34.
Vogl TJ et al (2018) Assessment of salivary gland tumors using MRI and CT: impact of experience on diagnostic accuracy. Radiol Med 123(2):105–116CrossRef
35.
Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L (2006) Risk factors for recurrence of shoulder instability after arthroscopic bankart repair. J Bone Jt Surg Ser A 88(8):1755–1763CrossRef
36.
Owens BD et al (2010) Pathoanatomy of first-time, traumatic, anterior glenohumeral subluxation events. J Bone Jt Surg Ser A 92(7):1605–1611CrossRef
37.
Chalmers PN, Christensen G, O’Neill D, Tashjian RZ (2020) Does bone loss imaging modality, measurement methodology, and interobserver reliability alter treatment in glenohumeral instability? Arthrosc J Arthrosc Relat Surg 36(1):12–19CrossRef
38.
Stillwater L, Koenig J, Maycher B, Davidson M (2017) 3D-MR vs. 3D-CT of the shoulder in patients with glenohumeral instability. Skelet Radiol 46(3):325–331CrossRef
39.
Funakoshi T, Hartzler RU, Stewien E, Burkhart SS (2019) Hill-Sachs lesion classification by the Glenoid track paradigm in shoulder instability: poor agreement between 3-dimensional computed tomographic and arthroscopic methods. Arthrosc J Arthrosc Relat Surg 35(6):1743–1749CrossRef
40.
Di Giacomo G, Itoi E, Burkhart SS (2014) Evolving concept of bipolar bone loss and the hill-sachs lesion: from ‘engaging/non-engaging’ lesion to ‘on-track/off-track’ lesion. Arthrosc J Arthrosc Relat Surg 30(1):90–98CrossRef
Metadata
Title
Reliability of humeral head measurements performed using two- and three-dimensional computed tomography in patients with shoulder instability
Authors
Jakub Stefaniak
A. M. Kubicka
A. Wawrzyniak
L. Romanowski
P. Lubiatowski
Publication date
01-10-2020
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 10/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-020-04710-x

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