2021 ISAKOS Biennial Congress ePoster
Diagnostic Value Of Measurements Methods For Bony Bankart Lesions
Mirco Sgroi, MD, Ulm GERMANY
Hashuka Huzurudin, MD, Ulm GERMANY
Marius Ludwig, MD, Ulm GERMANY
Heiko Reichel, Prof., Ulm GERMANY
Thomas Kappe, MD, Prof., Ulm GERMANY
Department for Orthopaedic Surgery, RKU, University of Ulm, Ulm, Germany, Ulm, GERMANY
FDA Status Not Applicable
Summary
Measurements Methods for Bony Bankart Lesions
ePosters will be available shortly before Congress
Abstract
Purpose
This study aimed to investigate the diagnostic validity of anterior-posterior (AP) radiographs, West Point view (WP) radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) in detecting glenoidal bone defects in patients with anterior shoulder instability compared to arthroscopic evaluation. Moreover, this study intended to compare the diagnostic precision of various measurement methods in quantifying the amount of bone loss using WP radiographs and MRI compared to CT.
Methods
A total of 80 consecutive patients with histories of anterior shoulder instability who have received arthroscopic treatment were retrospectively included in this study. The preoperative AP radiographs, WP radiographs, CT, and MRI of the affected shoulders were analyzed retrospectively. To assess the sensitivity (SE), specificity (SP), positive (PPV) and negative (NPV) predictive values, accuracy (AC), diagnostic odd ratio (DOR), positive (LR+) negative (LR-) likelihood ratio, and area under the curve (AUC), the radiological findings were compared with the intraoperative results. Furthermore, two independent observers evaluated the amount of bone loss using three measuring techniques: the bare spot method, best-fit circle method, and Gerber X-ratio. The resulting measurements performed on the AP radiographs, WP radiographs, and MRI were then compared with the CT results.
Results
A significant correlation between the WP radiographs (p = 0.019), CT (p < 0.0001), MRI (p < 0.0001), and intraoperative findings was found. The MRI showed the best AUC (0.823) compared to the CT (0.788) and WP radiographs (0.693). No significant difference between the measurements performed on the MRI and CT with the best-fit circle method (p = 0.568) and Gerber X-ratio (p = 0.851) was observed. Both measuring methods revealed excellent intra- and inter-rater reliabilities on the MRI and CT.
Conclusions
The results of this study confirm that the WP radiographs, CT, and MRI could accurately identify the glenoid bone defect in most patients with anterior shoulder instability. The higher AUC and correlation with arthroscopic findings suggest that MRI should be considered the gold standard. In addition, the results of this study regarding the quantification of bone loss indicate that the best-fit circle method and Gerber X-ratio can be performed with the same precision and excellent intra- and inter-rater reliabilities with CT and MRI.