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Arthroscopic bare spot method underestimates true bone defect in bony Bankart lesion.

Abstract：

INTRODUCTION:The need for precise quantification of the glenoid defect should be emphasized in the choice of surgery for bony Bankart lesion especially in its critical values of 16% to 25. The study aims to verify the validity of bare spot method for arthroscopic quantification of glenoid bone defect using several varieties of posterior portal location. MATERIALS AND METHODS:Two intact cadaveric glenoids were prepared for the study. The greatest anteroposterior diameter of the perfect circle concept of the glenoid is identified and center of the circle is marked as glenoid bare spot with metal marker. Sixteen percent and 25% defect were sequentially created using a saw at 0° axis parallel to the longitudinal axis of the glenoid. These were confirmed by 3D CT glenoid scan based on glenoid rim distances. Each glenoids were mounted on Sawbone dome holder model simulating neutral version. Quantification of Glenoid bone defects were sequentially measured by glenoid bare spot method arthroscopically by 5 shoulder arthroscopy trained surgeons in 5 varieties of posterior portals in 5 cycles. Paired sample t test was done for arthroscopic over CT scan method of glenoid bone loss quantification. One way ANOVA for portal location analysis was done. RESULTS:Glenoid bare spot method significantly underestimates 16% and 25% glenoid bone defect to 9% ± 2 (P < 0.001) and 18% ± 2 (P < 0.001), respectively, compared to 3D CT scan method. There was good intra-class correlation coefficient of 0.97 for inter-rater reliability. There was no significant difference in quantification in between five portal sites by one-way ANOVA (P > 0.05). CONCLUSIONS:Arthroscopic glenoid bare spot method using the anterior viewing portal significantly underestimates glenoid bone loss in critical margin degrees of decision making in shoulder instability surgery. Minimal variation of posterior portal location for the calibrated probe does not cause significant difference in Glenoid bone loss quantification.

journal_name

Arch Orthop Trauma Surg

journal_title

Archives of orthopaedic and trauma surgery

authors

Kho J,Kholinne E,Lim S,Hong H,Kwak JM,Sun Y,Koh KH,Jeon IH

doi

10.1007/s00402-019-03195-7

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

1269-1275

issue

eissn

0936-8051

issn

1434-3916

pii

10.1007/s00402-019-03195-7

journal_volume

139

pub_type

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Arthroscopic bare spot method underestimates true bone defect in bony Bankart lesion.