A comparative analysis of manual glenoid version measurement using two- and three-dimensional computed tomography...

Area of Science:

• Orthopedic surgery
• Radiology
• Medical imaging

Background:

• Accurate glenoid version measurement is crucial for successful shoulder arthroplasty.
• Glenoid version influences implant positioning and patient outcomes.
• Current imaging techniques for glenoid version assessment vary in accuracy and reliability.

Purpose of the Study:

• To compare the accuracy and reliability of unformatted 2D CT, formatted 2D CT, and 3D CT reconstructions for glenoid version measurement.
• To determine the best imaging method for reproducible glenoid version assessment in shoulder arthroplasty.
• To evaluate the clinical utility of formatted 2D CT as an alternative to 3D CT.

Main Methods:

• Retrospective analysis of shoulder CT scans from 65 patients undergoing arthroplasty.
• Glenoid version measured using unformatted 2D CT, formatted 2D CT, and 3D CT (Corrected Friedman Method) as the reference standard.
• Inter- and intra-observer reliability and minimally detectable difference were calculated for each method.

Main Results:

• No significant difference in mean glenoid version values across the three methods (P=0.245).
• Formatted 2D CT showed significantly higher agreement with 3D CT (95.4%) compared to unformatted 2D CT (83.1%) (P=0.023).
• 3D CT demonstrated the highest inter- and intra-observer reliability (ICC=0.83 and 0.91, respectively), followed by formatted 2D CT (ICC=0.83 and 0.83).

Conclusions:

• Three-dimensional CT (3D-CT) reconstructions are the gold standard for accurate and reproducible glenoid version assessment.
• Formatted 2D CT serves as a reliable alternative to 3D CT when 3D imaging is not feasible.
• Formatted 2D CT significantly outperforms unformatted 2D CT in accuracy and reliability for glenoid version measurement.