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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Determining glenoid component version after total shoulder arthroplasty
Manish P Mehta1, Laura A Vogel1, Brian B Shiu1
1Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA.
Journal of Shoulder and Elbow Surgery
|May 16, 2018
Summary
A new method accurately measures glenoid component version after total shoulder arthroplasty (TSA) using standard preoperative CT and postoperative x-rays. This technique avoids extra radiation and cost, improving TSA outcomes.
Area of Science:
- Orthopedic surgery
- Radiology
- Biomedical engineering
Background:
- Glenoid component loosening is a risk in total shoulder arthroplasty (TSA) if retroversion exceeds 10°.
- Accurate postoperative measurement of glenoid component version traditionally requires computed tomography (CT), increasing cost and radiation exposure.
- A novel, accessible method is needed to assess glenoid component version post-TSA using routine imaging.
Purpose of the Study:
- To introduce and validate a new method for measuring glenoid component version and inclination after TSA.
- To utilize only preoperative CT scans and postoperative radiographs (x-rays) for assessment.
- To compare the accuracy of this method against the gold standard of postoperative CT scans.
Main Methods:
- Preoperative glenoid version was measured using standard methods (axillary x-ray, 2D CT, Glenosys software).
- Postoperative version and inclination were measured for 61 TSA patients using Mimics software with preoperative CT and postoperative x-rays.
- Validation was performed on 14 cadavers, comparing the new method's results to gold standard postoperative CT measurements.
Main Results:
- The novel method demonstrated a measurement error of 2° ± 1° for both retroversion and inclination compared to the gold standard.
- 57% of patients (35/61) were corrected to <10° of retroversion, with an average correction of 6° ± 7°.
- Patients not corrected to <10° retroversion had significantly higher preoperative retroversion (14° ± 6°) than those who were corrected (6° ± 7°).
Conclusions:
- Glenoid component retroversion after TSA can be accurately measured using routine preoperative CT and postoperative x-rays, with accuracy within 1.9° of the gold standard.
- This accessible method can help identify patients needing correction to optimize shoulder arthroplasty outcomes.
- Future research should correlate glenoid retroversion correction with component longevity to further enhance TSA success.
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