Key result
3D CT using surface area measurement is the most reliable method for quantifying glenoid bone loss, as linear methods tend to overestimate bone loss, though no ideal standardized method currently exists.
Why the study?
Measuring glenoid bone loss to guide operative intervention is controversial, with studies using various methods lacking clear evidence of reproducibility.
Systematic Review (n=9)
3D CT using surface area measurement is currently the most reliable method for quantifying glenoid bone loss in anterior shoulder instability, as linear methods tend to overestimate the defect.
Prefer 3D CT surface area measurement to avoid overestimating glenoid loss in instability surgery; confirms current reliability ranking but leaves standardization unresolved.
Aims Recurrent dislocation is both a cause and consequence of glenoid bone loss, and the extent of the bony defect is an indicator guiding operative intervention. Literature suggests that loss greater than 25% requires glenoid reconstruction. Measuring bone loss is controversial; studies use different methods to determine this, with no clear evidence of reproducibility. A systematic review was performed to identify existing CT-based methods of quantifying glenoid bone loss and establish their reliability and reproducibility Methods A Preferred Reporting Items for Systematic reviews and Meta-Analyses-compliant systematic review of conventional and grey literature was performed. Results A total of 25 studies were initially eligible. Following screening, nine papers were included for review. Main themes identified compared 2D and 3D imaging, as well as linear- compared with area-based techniques. Heterogenous data were acquired, and therefore no meta-analysis was performed. Conclusion No ideal CT-based method is demonstrated in the current literature, however evidence suggests that surface area methods are more reproducible and lead to fewer over-estimations of bone loss, provided the views used are standardized. A prospective imaging trial is required to provide a more definitive answer to this research question. Cite this article: Bone Jt Open 2022;3(2):114–122.
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Green et al. (2022) conducted a systematic review in Anterior glenohumeral instability with glenoid bone loss (n=9). CT-based methods of quantifying glenoid bone loss (surface area vs linear, 3D vs 2D) vs. Other imaging modalities or measurement techniques was evaluated on Reliability and reproducibility of CT-based methods. 3D CT using surface area measurement is the most reliable method for quantifying glenoid bone loss, as linear methods tend to overestimate bone loss, though no ideal standardized method currently exists.
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