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Erschienen in: Skeletal Radiology 8/2008

01.08.2008 | Scientific Article

A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint

verfasst von: Vidal S. Barchilon, Eugene Kotz, Mercedes Barchilon Ben-Av, Ernesto Glazer, Meir Nyska

Erschienen in: Skeletal Radiology | Ausgabe 8/2008

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Abstract

Objective

The objective of this study was to describe and validate a simple method to quantitatively calculate the missing area of the anterior part of the glenoid in anterior glenohumeral instability.

Materials and methods

The calculations were developed from three-dimensional (3D)-reconstructed computerized tomography en face images of the glenoid with “subtraction” of the humeral head in 13 consecutive cases with known anterior glenohumeral joint instability diagnosed by history and clinical examination. The inferior portion of the glenoid was approximated to a true circle whose center was determined by means of a femoral head gauge. The eroded anterior area was calculated as the ratio between the depth (a perpendicular line from the center of the circle to the eroded edge of the anterior glenoid) and the radius of the inferior glenoid circle. This data was then compared to the results obtained by two additional different methods: direct computerized measurements of the missing area and direct computerized measurement of the ratio between the radius and depth, on two dimensional computed tomography (CT) en face view reconstructions of the glenoid.

Results

We provide a function that correlates the ratio between depth and radius of the inferior glenoid circle and the area of the missing anterior glenoid. The results obtained by three different methods were comparable. Simple trigonometric calculations showed that a 5% area defect corresponds to 0.8 (12.5%) of the radius of the inferior glenoid, while a 20% area defect corresponds to 0.5 (50%) of the same radius (Table 1).
Table 1
Results according to each different method
Patient
Sex
Side
CA1
MA1
PAM1
R2
D2
PAM2
R3
D3
PAM3
1
M
R
738
19.1
2.58
15.1
13.4
2.45
16
14
2.6
2
M
R
462.6
30.5
6.59
11.9
9.7
4.83
16
10
12.97
3
F
L
359
24.5
6.82
17
11.8
9.86
11.8
17
9.86
4
M
L
522
59.4
11.37
12.7
9.1
8.95
16
10
12.97
5
M
L
670
93.1
13.89
13.6
7.6
16.84
16
9
16.31
6
M
R
659
137.5
20.8
14.3
7.1
20.10
20
8
25.23
7
M
L
520
137
26.34
11.6
5.1
23.49
16
8
19.55
AVG
    
12.63
  
12.36
  
14.21
SD
    
8.46
  
7.92
  
7.20
CA1 Area of circle directly measured by MPR software, MA1 missing area of circle measured by MPR software, PAM1 calculated (100 × MA1/CA1) percentage area missing for method 1, R2 radius of the circle measured by MPR software, D2 depth from the missing edge to the center of the circle measured by MPR software, PAM2 calculated Percentage area missing from R2 and D2 using the function “q” (Appendix), R3 radius of the circle measured with a femoral gauge, D3 depth from the missing edge to the center of the circle measured with a femoral gauge, PAM3 calculated Percentage area missing from R3 and D3 using the function “q” (Appendix), AVG average, SD standard deviation

Conclusion

Using this simple method and the function provided, the eroded area of the anterior part of the glenoid in anterior glenohumeral instability can be calculated preoperatively using a 3D CT reconstruction of the glenoid with “subtraction” of the humeral head, obviating the need for sophisticated software to obtain this critical information for preoperative decision making.
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Metadaten
Titel
A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint
verfasst von
Vidal S. Barchilon
Eugene Kotz
Mercedes Barchilon Ben-Av
Ernesto Glazer
Meir Nyska
Publikationsdatum
01.08.2008
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 8/2008
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-008-0506-8

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