CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(06): 733-740
DOI: 10.1055/s-0040-1716766
Artigo Original
Ombro e Cotovelo

Evaluation of the Glenoid Track Tomographic Method in Magnetic Resonance Imaging/Arthro-MRI

Article in several languages: português | English
1   Hospital Ortopédico, Belo Horizonte, MG, Brasil
,
1   Hospital Ortopédico, Belo Horizonte, MG, Brasil
,
2   Ortopédico BH, Belo Horizonte, MG Brasil
,
3   Axial Medicina Diagnóstica, Belo Horizonte, MG, Brasil
,
2   Ortopédico BH, Belo Horizonte, MG Brasil
,
2   Ortopédico BH, Belo Horizonte, MG Brasil
› Author Affiliations

Abstract

Objective To evaluate and compare the glenoid track method in 3D-reconstructed computed tomography (3D-CT) scans with magnetic resonance imaging (MRI) and/or arthro-MRI.

Methods Forty-four shoulders with clinical and radiographic diagnosis of traumatic anterior instability were assessed using 3D-CT, MRI, and/or arthro-MRI scans. Glenoid track (GT), Hill-Sachs interval (HSI), and glenoid bone loss (GBL) were determined by a radiologist using 3D-CT images, and classified as on-track/off-track. Three surgeons, blinded to the radiologist's evaluation, performed the same determinations using MRI/arthro-MRI. Descriptive analysis, variance analysis, results disagreement analysis, and receiver operating characteristic (ROC) curves were performed.

Results Results from the 4 examiners were fully consistent in 61.4% of the cases. Magnetic resonance imaging/arthro-MRI diagnosed off-track injuries with 35 to 65% sensitivity and on-track injuries, with 91.67 to 95.83% specificity. Accuracy ranged from 68.1 to 79.5%. The greatest data divergence occurred for off-track injuries diagnosed by MRI/arthro-MRI. The greatest data variability referred to HSI calculation. Higher HSI and GBL values were associated with greater disagreement among examiners. Hill-Sachs interval values were lower at MRI/arthro-MRI when compared to 3D-CT. Agreement between CT and MRI/arthro-MRI for the GT method was only moderate (kappa value, 0.325–0.579).

Conclusion Magnetic resonance imaging/arthro-MRI showed low accuracy and moderate agreement for the GT method; as such, it should be used with caution by surgeons.



Publication History

Received: 09 December 2019

Accepted: 06 July 2020

Article published online:
29 October 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • Referências

  • 1 Momaya AM, Tokish JM. Applying the Glenoid Track Concept in the Management of Patients with Anterior Shoulder Instability. Curr Rev Musculoskelet Med 2017; 10 (04) 463-468
  • 2 França FO, Godinho A, Ribeiro E, Ranzzi A, Bittencourt BL, Barreto BB. Novo método quantitativo para medida da lesão de Hill-Sachs: validação do método radiográfico de Hardy para ressonância magnética/artro-RNM. Rev Bras Ortop 2018; 53 (05) 589-594
  • 3 Di Giacomo G, Itoi E, Burkhart SS. Evolving concept of bipolar bone loss and the Hill-Sachs lesion: from “engaging/non-engaging” lesion to “on-track/off-track” lesion. Arthroscopy 2014; 30 (01) 90-98
  • 4 Gyftopoulos S, Beltran LS, Bookman J, Rokito A. MRI Evaluation of Bipolar Bone Loss Using the On-Track Off-Track Method: A Feasibility Study. AJR Am J Roentgenol 2015; 205 (04) 848-852
  • 5 Metzger PD, Barlow B, Leonardelli D, Peace W, Solomon DJ, Provencher MT. Clinical Application of the “Glenoid Track” Concept for Defining Humeral Head Engagement in Anterior Shoulder Instability: A Preliminary Report. Orthop J Sports Med 2013; 1 (02) 2325967113496213
  • 6 Bigliani LU, Newton PM, Steinmann SP, Connor PM, Mcllveen SJ. Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med 1998; 26 (01) 41-45
  • 7 Burkhart SS, De Beer JF. 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 2000; 16 (07) 677-694
  • 8 Rabinowitz J, Friedman R, Eichinger JK. Management of Glenoid Bone Loss with Anterior Shoulder Instability: Indications and Outcomes. Curr Rev Musculoskelet Med 2017; 10 (04) 452-462
  • 9 Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 2000; 82 (01) 35-46
  • 10 Hill HA, Sachs MD. The grooved defect of the humeral head: afrequently unrecognized complication of dislocations of theshoulder joint. Radiology 1940; 35: 690-700
  • 11 Arciero RA, Parrino A, Bernhardson AS. et al. The effect of a combined glenoid and Hill-Sachs defect on glenohumeral stability: a biomechanical cadaveric study using 3-dimensional modeling of 142 patients. Am J Sports Med 2015; 43 (06) 1422-1429
  • 12 Kaar SG, Fening SD, Jones MH, Colbrunn RW, Miniaci A. Effect of humeral head defect size on glenohumeral stability: a cadaveric study of simulated Hill-Sachs defects. Am J Sports Med 2010; 38 (03) 594-599
  • 13 Yamamoto N, Itoi E, Abe H. et al. Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track. J Shoulder Elbow Surg 2007; 16 (05) 649-656
  • 14 Huijsmans PE, Haen PS, Kidd M, Dhert WJ, van der Hulst VP, Willems WJ. Quantification of a glenoid defect with three-dimensional computed tomography and magnetic resonance imaging: a cadaveric study. J Shoulder Elbow Surg 2007; 16 (06) 803-809
  • 15 Schneider AK, Hoy GA, Ek ET. et al. Interobserver and intraobserver variability of glenoid track measurements. J Shoulder Elbow Surg 2017; 26 (04) 573-579
  • 16 Funakoshi T, Hartzler RU, Stewien E, Burkhart SS. Hill-Sachs Lesion Classification by the Glenoid Track Paradigm in Shoulder Instability: Poor Agreement Between 3-Dimensional Computed Tomographic and Arthroscopic Methods. Arthroscopy 2019; 35 (06) 1743-1749