Variability in quantifying the Hill-Sachs lesion: A scoping review
Shahrukh Khan1, Ajaykumar Shanmugaraj2, Haseeb Faisal1
1Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Shoulder & Elbow
|October 9, 2023
Summary
Accurate measurement of Hill-Sachs lesions (HSL) lacks consensus. Magnetic Resonance Arthrography (MRA) and Magnetic Resonance Imaging (MRI) demonstrate high diagnostic accuracy for HSL assessment, though comparative studies are needed.
Area of Science:
- Orthopedic Surgery
- Radiology
- Sports Medicine
Background:
- A definitive measurement technique for Hill-Sachs lesions (HSL) is not established.
- Pre-operative assessment of HSLs requires standardized techniques and imaging modalities.
Purpose of the Study:
- To review current techniques and imaging modalities for pre-operative Hill-Sachs lesion assessment.
- To provide an overview of diagnostic properties and measurement methods for HSLs.
Main Methods:
- A systematic literature search was conducted across four databases (PubMed, Embase, MEDLINE, COCHRANE) up to November 2021.
- Forty-five studies involving 3413 patients were included.
- Study quality was assessed using the Methodological Index for Non-Randomized Studies tool.
Main Results:
- Magnetic Resonance Arthrography (MRA) and Magnetic Resonance Imaging (MRI) exhibited the highest sensitivity, specificity, and accuracy for HSL detection.
- MRA demonstrated the highest intrarater and interrater agreement.
- Common reference methods included arthroscopy, radiography, arthro-CT, and surgical techniques.
Conclusions:
- MRA and MRI are reliable imaging modalities for HSL assessment with good diagnostic properties.
- A lack of comparative studies prevents definitive conclusions on the superiority of any single technique.
- Future research should focus on comparative studies of imaging modalities and measurement techniques, including cost-benefit analyses.
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