Intra- and Inter-rater Reliability of Postoperative Radiographic Analysis of Reverse Shoulder Arthroplasty in 49 Shoulders After Proximal Humerus Fracture,Indian Journal of Orthopaedics

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Intra- and Inter-rater Reliability of Postoperative Radiographic Analysis of Reverse Shoulder Arthroplasty in 49 Shoulders After Proximal Humerus Fracture
Indian Journal of Orthopaedics ( IF 1.1 ) Pub Date : 2022-08-30 , DOI: 10.1007/s43465-022-00716-2
Pierre Tuphé ₁ , Ines Regas ₁ , Fiona Sakek ₁ , Harrison Haight ₁ , Isabelle Pluvy ₁ , Tristan Lascar ₂ , Laurent Obert ₁ , François Loisel ₁

Affiliation

Introduction

The lateralization shoulder angle (LSA), the distalization shoulder angle (DSA) and the new “pentagon” concept are tools used in scheduled shoulder surgery to evaluate the positioning of reverse shoulder arthroplasty (RSA) implants. There is no information on the intra- and inter-rater reliability of these tools in the context of RSA for a proximal humerus fracture. The first hypothesis was the high reliability of the intra- and inter-rater analysis of the LSA and DSA angles. The second hypothesis was the reproductibility of the pentagon based on LSA and DSA analysis.

Methods

Forty-nine patients were evaluated retrospectively with a minimum of 2 years radiological follow-up after RSA surgery. Tuberosity healing was evaluated using an AP radiograph of the shoulder and their location analyzed within the said “pentagon” defined by the LSA/DSA angles and the maximum lengthening recommended.

Results

The intra-rater analysis found strong to an almost perfect agreement for the LSA and DSA. The agreement was moderate to strong for the pentagon. The inter-rater analysis found a fair agreement for the LSA and moderate agreement for the DSA and pentagon.

Conclusion

The LSA/DSA is used in patients undergoing RSA for glenohumeral OA. In this context, the tuberosities were intact and certain complications inherent to RSA for humeral fracture were not present. The population studied here (RSA after fracture) creates an interpretation bias due to the difficulty in analyzing tuberosity position.

Level of Evidence

4, retrospective study.

中文翻译：

49 例肱骨近端骨折后反向肩关节置换术后放射学分析的内部和评估者间可靠性

介绍

侧化肩角 (LSA)、远侧化肩角 (DSA) 和新的“五边形”概念是预定肩部手术中用于评估反向肩关节置换术 (RSA) 植入物定位的工具。没有关于这些工具在肱骨近端骨折 RSA 背景下的评估者内部和评估者间可靠性的信息。第一个假设是 LSA 和 DSA 角度的评估者内和评估者间分析的高可靠性。第二个假设是基于 LSA 和 DSA 分析的五边形的再现性。