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European Journal of Orthopaedic Surgery & Traumatology

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01-05-2015 | Original Article

The intra- and inter-observer reliability of the CT-scan based X index to quantify glenoid bone loss in chronic anterior shoulder instability and its impact on decision making

Authors: Ali Maqdes, Yves Chammai, Regis Lengert, Shahnaz Klouche, Philippe Clavert, Philippe Hardy, Jean-Francois Kempf

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 4/2015

Abstract

Purpose

The X index is a measure of the antero-inferior glenoid bone loss on unilateral 2D CT-scans in the preoperative analysis of chronic anterior shoulder instability. Recurrence rate was shown to be higher after stabilization surgery if X index is superior or equal to 0.4. The objective of this study was to assess the intra- and inter-observer reliability of the X index.

Methods

Sixty patients with an X index ≥0.4 were included retrospectively. The X index was measured twice by two independent evaluators, 15 days apart. The measurement was performed on a unilateral 2D CT-scan by dividing the length of the antero-inferior glenoid defect over the maximal antero-posterior diameter of the glenoid. Reliability of X index was assessed with intra-class correlation coefficient (ICC, ρ). Two points were added to the ISIS calculation if its glenoid criterion was “zero” and we compared this modified score to the original one.

Results

The intra-observer reliability of the X index measurement was “excellent” (ρ = 0.95 ± 0.01, p < 0.0001) while the inter-observer reliability was “good” (ρ = 0.59 ± 0.08, p < 0.0001). In patients with a glenoid bone loss visualized by the X index, 48.3 % had a negative sclerotic glenoid line sign. This proportion significantly decreased with the augmentation of the X index, p = 0.02. The average original ISIS score was 3.4 ± 1.9 and became 4.3 ± 1.7 (p < 0.00001) when the X index was incorporated.

Conclusions

The X index is a reliable and simple unilateral 2D CT-scan measurement. AP shoulder radiographs significantly underestimated glenoid bony lesions.

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Title: The intra- and inter-observer reliability of the CT-scan based X index to quantify glenoid bone loss in chronic anterior shoulder instability and its impact on decision making
Authors: Ali Maqdes
Yves Chammai
Regis Lengert
Shahnaz Klouche
Philippe Clavert
Philippe Hardy
Jean-Francois Kempf
Publication date: 01-05-2015
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 4/2015
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-014-1546-5

At a glance: The STEP trials

Springer Medicine

The intra- and inter-observer reliability of the CT-scan based X index to quantify glenoid bone loss in chronic anterior shoulder instability and its impact on decision making

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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