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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.

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|May 16, 2018
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
3D modelGlenoidmimicsreplacementretroversionshouldertotal shoulder arthroplastyversion

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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.