Determining On-/Off-track Lesions in Glenohumeral Dislocation Using Multiplanar Reconstruction Computed Tomography Is...

Area of Science:

• Orthopedic surgery and imaging analysis.
• Shoulder instability and biomechanics.

Background:

• The glenoid track is crucial for predicting recurrent shoulder dislocation risk in patients with Hill-Sachs and/or bony Bankart lesions.
• Current preoperative glenoid track assessment relies on 3-dimensional reconstruction (3DR), which lacks standardized, reliable, and easy protocols.

Purpose of the Study:

• To evaluate a novel computed tomography (CT) scan multiplanar reconstruction (MPR) method for glenoid track assessment.
• To compare the MPR method against 3DR imaging for accuracy, standardization, and reproducibility.
• To test the hypothesis that MPR offers superior standardization and reproducibility.

Main Methods:

• A cohort study included 52 patients with Hill-Sachs lesions (with or without bony Bankart lesions) assessed via arthro-CT scans.
• Glenoid width and Hill-Sachs interval (HSI) were measured using both MPR and 3DR techniques on open-source image analysis software.
• Intra- and interobserver reliability were evaluated for both measurement methods.

Main Results:

• Minimal absolute differences were observed between MPR and 3DR methods (max HSI difference: 0.07 cm; max glenoid width difference: 0.04 cm).
• Glenoid measurements showed similar results between MPR and 3DR.
• The MPR method demonstrated superior inter- and intraobserver reliability for humeral measurements compared to 3DR.

Conclusions:

• The novel MPR method for glenoid track and HSI assessment is as accurate as the 3DR method.
• MPR offers enhanced intra- and interobserver reliability and is easier to obtain.
• The MPR method is recommended for routine clinical practice due to its accuracy, reliability, and ease of use.