A Three-Dimensional CT Technique to Assess Early Implant Migration and Radiolucency Lines in Total Shoulder Arthroplasty

2021 ◽  
Vol 30 (7) ◽  
pp. e451-e452
Author(s):  
Cyrus Brodén ◽  
Peter Reilly ◽  
Olof Sköldenberg ◽  
Henrik Olivecrona ◽  
Roger Emery
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Implant Migration ◽  
Ct Technique

Preoperative three-dimensional computer planning for reverse total shoulder arthroplasty and bone grafting for severe glenoid deformity

2020 ◽  
pp. 175857322090890
Author(s):  
Robert Z Tashjian ◽  
Lindsay Beck ◽  
Irene Stertz ◽  
Peter N Chalmers
Keyword(s):  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation ◽  
Reverse Total Shoulder ◽  
Glenoid Erosion

Background Computer assisted planning without patient specific instrumentation may be utilized to guide reverse total shoulder arthroplasty baseplate placement. The purpose of this study was to determine the difference between planned and achieved inclination and retroversion correction with three-dimensional preoperative computer assisted planning in reverse total shoulder arthroplasty without patient specific instrumentation with bone grafting for severe glenoid erosion. Methods Preoperative three-dimensional computer assisted planning without patient specific instrumentation was performed on 15 patients undergoing primary reverse total shoulder arthroplasty with glenoid bone grafting for severe glenoid erosion. On preoperative and immediate postoperative computed tomography slices, two-dimensional retroversion and inclination were measured. Preoperative three-dimensional baseline retroversion and inclination and planned postoperative three-dimensional retroversion and inclination were measured. Planned and achieved version and inclination changes were compared. Results The planned and achieved retroversion corrections were 18° and 12°, respectively (p < 0.001). The planned and achieved inclination corrections were 11° and 11°, respectively (p = 0.803). Conclusions Three-dimensional computer assisted planning without patient specific instrumentation in the setting of reverse total shoulder arthroplasty with severe glenoid erosion requiring bone grafting can accurately guide baseplate placement. All cases in which failure to correct retroversion or inclination within 10° of planning occurred in patients with severe erosion (B3 or E3 glenoids), therefore patient specific guides may be warranted in these cases to improve accuracy of implantation. Level of evidence Level IV, retrospective case series.

The influence of three-dimensional planning on decision-making in total shoulder arthroplasty

2017 ◽  
Vol 26 (8) ◽  
pp. 1477-1483 ◽  
Author(s):  
Birgit S. Werner ◽  
Robert Hudek ◽  
Klaus J. Burkhart ◽  
Frank Gohlke
Keyword(s):  
Decision Making ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional

scholarly journals A Robotic Glenohumeral Simulator for Investigating Prosthetic Implant Subluxation

2019 ◽  
Vol 142 (1) ◽  
Author(s):  
Matteo Mancuso ◽  
Arash Arami ◽  
Fabio Becce ◽  
Alain Farron ◽  
Alexandre Terrier ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Implant Design ◽  
Joint Stability ◽  
Dynamic Forces ◽  
Prosthetic Implant ◽  
Robotic Simulator ◽  
Real Patients

Abstract Total shoulder arthroplasty (TSA) is an effective treatment for glenohumeral (GH) osteoarthritis. However, it still suffers from a substantial rate of mechanical failure, which may be related to cyclic off-center loading of the humeral head on the glenoid. In this work, we present the design and evaluation of a GH joint robotic simulator developed to study GH translations. This five-degree-of-freedom robot was designed to replicate the rotations (±40 deg, accuracy 0.5 deg) and three-dimensional (3D) forces (up to 2 kN, with a 1% error settling time of 0.6 s) that the humeral implant exerts on the glenoid implant. We tested the performances of the simulator using force patterns measured in real patients. Moreover, we evaluated the effect of different orientations of the glenoid implant on joint stability. When simulating realistic dynamic forces and implant orientations, the simulator was able to reproduce stable behavior by measuring the translations of the humeral head of less than 24 mm with respect to the glenoid implant. Simulation with quasi-static forces showed dislocation in extreme ranges of implant orientation. The robotic GH simulator presented here was able to reproduce physiological GH forces and may therefore be used to further evaluate the effects of glenoid implant design and orientation on joint stability.

Sequential three-dimensional computed tomography analysis of implant position following total shoulder arthroplasty

2016 ◽  
Vol 25 (6) ◽  
pp. e168-e169
Author(s):  
Eric T. Ricchetti ◽  
Richard A. Cain ◽  
Bong-Jae Jun ◽  
Ari R. Youderian ◽  
Eric J. Rodriguez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Implant Position ◽  
Tomography Analysis

scholarly journals The fulcrum axis: an accurate measure of glenoid version on radiographs and computed tomography

2017 ◽  
Vol 11 (2) ◽  
pp. 79-86
Author(s):  
Jennifer Mutch ◽  
Martin Sidler ◽  
Claudia Sidler-Maier ◽  
Terry Axelrod ◽  
Diane Nam
Keyword(s):  
Computed Tomography ◽  
Shoulder Arthroplasty ◽  
Gold Standard ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Absolute Difference ◽  
Single Institution ◽  
Glenoid Version ◽  
Rater Reliability ◽  
The Mean

Background Proper glenoid position in total shoulder arthroplasty (TSA) is important. However, traditional glenoid version (GV) measurements overestimate retroversion on radiographs (XR) and computed tomography (CT). The fulcrum axis (FA) uses palpable surface landmarks and may be useful as an intra-operative guide. Also, the FA has not yet been validated on XR or CT in an arthritic population. Methods Four observers measured FA and GV on the XR, CT and three-dimensional CT (3DCT) of 40 patients who underwent TSA at a single institution from 2009 to 2015. Reliability and accuracy of FA and GV were calculated for XR and CT, using 3DCT as the gold standard. Results The mean FA and GV were 7.768° and 18.910° on XR; 6.23° and 12.920° on CT; and 8.100° and 7.740° on 3DCT, respectively. FA and GV were significantly different for XR and CT ( p < 0.001) but not for 3DCT ( p = 0.725). The inter-rater reliability, intra-rater reliability and accuracy of FA were not significantly different from GV and were 0.929 to 0.948, 0.779 to 0.974 and 0.674 to 0.705, respectively. However, the absolute difference of FA was closer to the gold standard (3DCT) than GV for XR (0.330° versus 11.172°) and CT (1.871° versus 5.178°) ( p < 0.001). Conclusions FA showed comparable reliability and accuracy to GV. However, FA more accurately reflected the gold standard.

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