Does Bone Loss Imaging Modality, Measurement Methodology, and Interobserver Reliability Alter Treatment in Glenohumeral Instability?

Chalmers, Peter N.; Christensen, Garrett V.; O’Neill, Dillon C.; Tashjian, Robert Z.

doi:10.1016/j.arthro.2019.06.025

Cited by 19 publications

(10 citation statements)

References 47 publications

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“…Traditional X-ray allows us to diagnose the presence of a defect only in about 7% of cases after the first dislocation episode, in comparison, computed tomography or magnetic resonance tomography images are much more accurate and allow us to determine the presence of a defect in more than 90% of cases [ 36 ]. Chalmers et al report that linear measurements resulted in most aggressive recommendations of treatment [ 37 ]. Stillwater et al assessed that there are no significant differences between measurements performed on 3D-CT and 3D-MR postprocessed images [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

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

Stefaniak

Kubicka

Wawrzyniak

et al. 2020

International Orthopaedics (SICOT)

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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.

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Section: Discussionmentioning

confidence: 99%

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

Stefaniak

Kubicka

Wawrzyniak

et al. 2020

International Orthopaedics (SICOT)

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“…Chalmers et al. 20 showed good inter-rater reliability for GBL measurements from MRI; however, this was derived from measurements by 2 surgeons who were given preselected MRI slices from which to measure. Furthermore, the authors noted that despite ICCs within an acceptable range, the differences reported between the 2 observers would still have resulted in different treatment recommendations in over 30% of cases in their analysis.…”

Section: Discussionmentioning

confidence: 99%

The Perfect Circle Technique Shows Poor Inter-rater Reliability in Measuring Anterior Glenoid Bone Loss on Magnetic Resonance Imaging

Parnes,

Green,

Wynkoop

et al. 2024

Arthroscopy, Sports Medicine, and Rehabilitation

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“…The lack of a universally accepted preoperative method to quantify glenoid bone loss, the low reliability of currently established measurement methods, and subjective decision-making regarding glenoid deficiency are possibly reasons for progressive changes in critical bone loss values over time in the literature, reaching as low as 13%. 13 , 21 , 22 Following this, Chalmers et al 6 showed that differences in measurement methods with the lack of a gold standard may lead to differences in the choice of treatment in up to 34% of cases, with the most aggressive treatment recommendations associated with linear-based (1D) CT measurements. This seems to be mostly true, especially for manually performed measurements, as manually performed 1D and 2D measurements tend to underestimate the glenoid defect compared to automated measurements, as shown in our study possibly because of the above mentioned errors.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Manual Measurements Versus Semiautomated Software for Glenoid Bone Loss Quantification in Patients With Anterior Shoulder Instability

Karpinski,

Akguen,

Gebauer

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: The presence of glenoid bone defects is indicative in the choice of treatment for patients with anterior shoulder instability. In contrast to traditional linear- and area-based measurements, techniques such as the consideration of glenoid concavity have been proposed and validated. Purpose: To compare the reliability of linear (1-dimensional [1D]), area (2-dimensional [2D]), and concavity (3-dimensional [3D]) measurements to quantify glenoid bone loss performed manually and to analyze how automated measurements affect reliability. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Computed tomography images of 100 patients treated for anterior shoulder instability with differently sized glenoid defects were evaluated independently by 2 orthopaedic surgeons manually using conventional software (OsiriX; Pixmeo) as well as automatically with a dedicated prototype software program (ImFusion Suite; ImFusion). Parameters obtained included 1D (defect diameter, best-fit circle diameter), 2D (defect area, best-fit circle area), and 3D (bony shoulder stability ratio) measurements. Mean values and reliability as expressed by the intraclass correlation coefficient [ICC]) were compared between the manual and automated measurements. Results: When manually obtained, the measurements showed almost perfect agreement for 1D parameters (ICC = 0.83), substantial agreement for 2D parameters (ICC = 0.79), and moderate agreement for the 3D parameter (ICC = 0.48). When measurements were aided by automated software, the agreement between raters was almost perfect for all parameters (ICC = 0.90 for 1D, 2D, and 3D). There was a significant difference in mean values between manually versus automatically obtained measurements for 1D, 2D, and 3D parameters ( P < .001 for all). Conclusion: While more advanced measurement techniques that take glenoid concavity into account are more accurate in determining the biomechanical relevance of glenoid bone loss, our study showed that the reliability of manually performed, more complex measurements was moderate.

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Does Bone Loss Imaging Modality, Measurement Methodology, and Interobserver Reliability Alter Treatment in Glenohumeral Instability?

Cited by 19 publications

References 47 publications

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

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

The Perfect Circle Technique Shows Poor Inter-rater Reliability in Measuring Anterior Glenoid Bone Loss on Magnetic Resonance Imaging

Reliability of Manual Measurements Versus Semiautomated Software for Glenoid Bone Loss Quantification in Patients With Anterior Shoulder Instability

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