{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:41:10Z","timestamp":1791895270694,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:00:00Z","timestamp":1549411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:00:00Z","timestamp":1549411200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Glenoid bone integrity is crucial for shoulder stability. The purpose of this study was to investigate a non\u2010invasive method for quantifying bone loss regarding reliability and accuracy to detect glenoid bone deficiency in standard two\u2010dimensional (2D) and three\u2010dimensional (3D) computed tomography (CT) measurements at different time points. It was hypothesized that the diameter of the circle used would significantly differ between raters, rendering this method inaccurate and not allowing for an exact estimation of glenoid defect size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010two shoulder CTs from 26 patients (26 2D\u2010CTs; 26 3D\u2010CTs) with anterior glenoid bone defects were evaluated by 6 raters at time 0 (T0) and at least 3 weeks after (T1) to assess the glenoid bone defect using the ratio method (\u201cbest fit circle\u201d). Inter\u2010 and intra\u2010rater differences concerning circle dimensions (circle diameter), measured width of bone loss and calculated percentage of bone loss (length\u2010width\u2010ratio) were compared in 2D\u2010 versus 3D\u2010CT scans. The intraclass coefficient (ICC) was used to determine the inter\u2010 and intra\u2010rater agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean circle diameter difference in 2D\u2010CT was 2.0\u2009\u00b1\u20091.9\u00a0mm versus 1.8\u2009\u00b1\u20091.5\u00a0mm in 3D\u2010CT, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Mean width of bone loss in 2D\u2010CT was 1.9\u2009\u00b1\u20091.7\u00a0mm compared to 1.7\u2009\u00b1\u20091.5\u00a0mm in 3D\u2010CT, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The mean difference of bone loss percentage was 5.1\u2009\u00b1\u20094.8% in 2D\u2010CT and 4.8\u2009\u00b1\u20094.5% in 3D\u2010CT (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). No significant differences concerning circle diameter, bone loss width and bone loss percentage were detected comparing T0 and T1. Circle diameter, bone loss width and bone loss percentage measurements in 3D\u2010CT were significantly smaller compared to 2D\u2010CT at T0 and T1 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Agreement (ICC) was fair to good for all indicators of circle diameter (range 0.76\u20130.83), bone loss width (range 0.76\u20130.86) and percentage of bone loss (range 0.85\u20130.91). Overall, 3D\u2010CT showed superior agreement compared to 2D\u2010CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ratio method varies in all glenoid parameters and is not valid for consistently quantifying glenoid bone defects even in 3D computed tomography. This must be taken into consideration when determining proper surgical treatment. The degree of glenoid bone loss alone should not be used to decide for or against a bony procedure. Rather, it is more important to define a defect size as \u201ccritical\u201d and to also take other patient\u2010specific factors into consideration so that the best treatment option can be undertaken. Application of the \u201cbest fitting circle\u201d is a source of error when using the ratio method; therefore, care should be taken when measuring the circle diameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-019-05391-9","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T06:24:26Z","timestamp":1549434266000},"page":"3222-3229","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Insufficient consensus regarding circle size and bone loss width using the ratio\u2014\u201cbest fit circle\u201d\u2014method even with three\u2010dimensional computed tomography"],"prefix":"10.1002","volume":"27","author":[{"given":"Lucca","family":"Lacheta","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Sports Medicine Technical University of Munich Ismaninger Strasse 22 81675 Munich Germany"},{"name":"<!--<label>6<\/label>--> Steadman Philippon Research Institute 181 West Meadow Drive 81657 Vail CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Herbst","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Trauma\u2010, Hand\u2010 and Reconstructive Surgery Westfaelian\u2010Wilhelms University of Muenster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Voss","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Sports Medicine Technical University of Munich Ismaninger Strasse 22 81675 Munich Germany"},{"name":"<!--<label>8<\/label>--> Department of Trauma Surgery University Hospital Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepp","family":"Braun","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Gelenkpunkt\u2010Sports and Joint Surgery Innsbruck Olympiastrasse 39 6020 Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Jungmann","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Radiology University Medical Center Freiburg Hugstetter Stra\u00dfe 55 79106 Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Millett","sequence":"additional","affiliation":[{"name":"<!--<label>5<\/label>--> The Steadman Clinic 181 West Meadow Drive 81657 Vail CO USA"},{"name":"<!--<label>6<\/label>--> Steadman Philippon Research Institute 181 West Meadow Drive 81657 Vail CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Imhoff","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Sports Medicine Technical University of Munich Ismaninger Strasse 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1027-8893","authenticated-orcid":false,"given":"Frank","family":"Martetschl\u00e4ger","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Sports Medicine Technical University of Munich Ismaninger Strasse 22 81675 Munich Germany"},{"name":"<!--<label>7<\/label>--> Department of Shoulder and Elbow Surgery ATOS Clinic Munich Effnerstrasse 38 81925 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,6]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010012\u20102607\u2010x"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200608000\u201000010"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512458247"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.17715"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.10.008"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749\u20108063(03)00684\u20104"},{"key":"e_1_2_8_8_2","first-page":"6","article-title":"Impact of sagittal rotation on axial glenoid width measurement in the setting of glenoid bone loss","volume":"47","author":"Frank RM","year":"2018","journal-title":"Am J Orthop (Belle Mead 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November 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Frank Martetschl\u00e4ger and Sepp Braun have received consulting fees from Arthrex. Andreas Imhoff has received consulting fees from Arthrex, Arthrosurface and Medi Bayreuth. Peter J. Millett has received consulting fees from Arthrex, Medbridge, Springer Publishing and royalties from Arthrex. Peter J. Millett has stock options in VuMedi and GameReady. Research activities at Steadman Philippon Research Institute are supported by Vail Valley Medical Center and corporate sponsorships by Smith&Nephew, Arthrex, Siemens and \u00d6ssur. Elmar Herbst, Andreas Voss, Pia Jungmann and Lucca Lacheta declare no conflict of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study is in accordance with the institutional ethic guidelines and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}