Abstract

Purpose

The purpose of this study was to clinically validate the Hill–Sachs interval to glenoid track width ratio (H/G ratio) compared with the instability severity index (ISI) score for predicting an increased risk of recurrent instability after arthroscopic Bankart repair.

Methods

A retrospective evaluation was performed using data from patients with anteroinferior shoulder instability who underwent arthroscopic Bankart repair with a follow-up period of at least 24 months. A receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values for the H/G ratio and the ISI score to predict an increased risk of recurrent instability. The area under the ROC curve (AUC) of the two methods and the sensitivity and specificity of their optimal cut-off values were compared.

Results

A total of 222 patients were included, among whom 31 (14.0%) experienced recurrent instability during the follow-up period. The optimal cut-off values for predicting an increased risk of recurrent instability were an H/G ratio of ≥ 0.7 and ISI score of ≥ 4. There were no significant differences between the AUC of the two methods (H/G ratio AUC = 0.821, standard error = 0.035 and ISI score AUC = 0.792, standard error = 0.04; n.s.) nor between the sensitivity and specificity of the optimal cut-off values (n.s. and n.s., respectively).

Conclusions

The H/G ratio is comparable to the ISI score for predicting an increased risk of recurrent instability after arthroscopic Bankart repair. Surgeons are recommended to consider other strategies to treat anterior shoulder instability if H/G ratio is ≥ 0.7.

Level of evidence

III.

中文翻译：

---

希尔-萨克斯间隔与盂关节轨迹宽度之比与关节镜Bankart修复后可预测复发性不稳定风险的不稳定性严重程度评分相当

摘要

目的

这项研究的目的是通过临床上验证Hill-Sachs间隔与关节盂径的宽度比（H / G比）与不稳定性严重性指数（ISI）得分的比较，以预测关节镜行Bankart修复后复发性不稳定性的风险增加。

方法

使用来自前下肩关节不稳患者的数据进行回顾性评估，这些患者接受了关节镜行Bankart修复，随访期至少为24个月。接收器工作特性（ROC）曲线用于确定H / G比和ISI得分的最佳临界值，以预测复发性不稳定的风险增加。比较了这两种方法的ROC曲线下面积（AUC）以及它们的最佳临界值的敏感性和特异性。

结果

包括222例患者，其中31例（14.0％）在随访期间经历了反复不稳定。预测复发性不稳定风险增加的最佳临界值是H / G比≥0.7和ISI分数≥4。两种方法的AUC之间无显着差异（H / G比AUC = 0.821） ，标准误差= 0.035，ISI评分AUC = 0.792，标准误差= 0.04; ns），也不在最佳临界值（分别为ns和ns）的敏感性和特异性之间。

结论

H / G比与ISI评分相当，可预测关节镜Bankart修复后复发性不稳定的风险增加。如果H / G比≥0.7，建议外科医生考虑其他治疗前肩不稳的方法。

证据水平

三，