Computed Tomography Versus Simple Radiography for Detecting and Classifying Heterotopic Ossification after Reverse...

Area of Science:

• Orthopedic Surgery
• Radiology
• Medical Imaging

Background:

• Heterotopic ossification (HO) following reverse shoulder arthroplasty (RSA) presents challenges in radiographic characterization.
• Evaluating the reliability of simple radiography versus computed tomography (CT) for HO assessment is crucial.

Purpose of the Study:

• To compare the intraobserver and interobserver reliability of simple radiography and CT in detecting and classifying HO after RSA.
• To analyze the correlation between HO identified via radiography/CT and clinical outcomes.

Main Methods:

• Retrospective review of 30 patients who underwent RSA, with immediate and 1-year postoperative radiographs and CT scans.
• Intraobserver and interobserver reliability assessed using Kappa statistics for HO detection and Modified Brooker's classification.
• Correlation analysis between radiographic findings and clinical scores (UCLA, SF-36).

Main Results:

• Both radiography and CT demonstrated excellent intraobserver reliability for HO detection and classification.
• CT significantly improved interobserver reliability for HO detection (Kappa: 0.8316 vs. 0.6018) and classification (0.6964 vs. 0.5300) compared to radiography.
• HO detected by CT, but not radiography, correlated with lower UCLA and SF-36 physical scores.

Conclusions:

• Simple radiography and CT offer high intraobserver reliability for HO assessment post-RSA.
• CT enhances interobserver reliability and provides clearer definition of HO presence and severity compared to simple radiography.
• CT-based HO assessment is more strongly associated with diminished clinical outcomes after RSA.