Reliability of a novel 3-dimensional computed tomography method for reverse shoulder arthroplasty postoperative evaluation

Objective To verify whether reverse baseplate positioning without the support of intraoperative three-dimensional technology is within the acceptable parameters in the literature and whether glenoid bone deformity (GBD) compromises this positioning. Methods Sixty-nine reverse shoulder arthroplasties were evaluated with volumetric computed tomography (CT). Two radiologists performed blinded CT scan analysis and evaluated baseplate position within 2mm of the inferior glenoid; the inclination and version of the baseplate in relation to the Friedman line; and upper and lower screw and baseplate metallic peg end point positionings. The patients were divided according to the presence of GBD for statistical analyses. Results The two radiologists concurred reasonably in their interpretations of the following analyzed parameters: baseplate position within 2mm of the inferior glenoid rim (97.1% and 95.7%), baseplate inclination (82.6% and 81.2%), baseplate version (69.6% and 56.5%), the upper screw reaching the base of the coracoid process (71% and 79.7%), the inferior screw remaining inside the scapula (88.4% and 84.1%), and the metallic peg of the baseplate considered intraosseous (88.4% and 72.5%). Conclusion Reverse baseplate positioning without intraoperative three-dimensional technology is within the acceptable parameters of the literature, except for baseplate version and upper screw position. GBD did not interfere with baseplate positioning in reverse shoulder arthroplasty.

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Development and assessment of 3-dimensional computed tomography measures of proximal humeral bone density: a comparison to established 2-dimensional measures and intraoperative findings in patients undergoing shoulder arthroplasty

JSES International ◽

10.1016/j.jseint.2021.07.015 ◽

2021 ◽

Author(s):

William G. Blakeney ◽

Manuel Urvoy ◽

Jean Chaoui ◽

Patric Raiss ◽

George S. Athwal ◽

...

Keyword(s):

Computed Tomography ◽

Bone Density ◽

Shoulder Arthroplasty ◽

3 Dimensional

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The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03690-8 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Omer Ozel ◽

Robert Hudek ◽

Mohamed S. Abdrabou ◽

Birgit S. Werner ◽

Frank Gohlke

Keyword(s):

Computed Tomography ◽

Rotator Cuff ◽

Inclination Angle ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Fatty Infiltration ◽

Critical Shoulder Angle ◽

Software Program ◽

3D Software ◽

Shoulder Angle

Abstract Background The success of shoulder arthroplasty, both reverse and anatomical, depends on correcting the underlying glenoid deformity especially in patients with an osteoarthritis. We hypothesized that the distribution of glenoid version and especially inclination are underestimated in the shoulder arthritis population, and also that superior glenoid inclination can be detected through 3-dimensional (3D) software program of computed tomography (CT) to a greater proportion in patients with rotator cuff insufficiency, but also in patients with osteoarthritis with an intact rotator cuff. Because of the influence of rotator cuff imbalance on secondary glenoid wear the values of the critical shoulder angle (CSA) and the fatty infiltration of the rotator cuff are further analyzed. The aim of our study is to determine; 1) the distribution of glenoid inclination and version; 2) the relationship between glenoid inclination, version, the critical shoulder angle (CSA) to the status of the rotator cuff; 3) the proportion of patients with both an intact rotator cuff and a superior inclination greater than 10°. Methods A total of 231 shoulders were evaluated with X-ray images, 3-dimentional (3D) software program of computed tomography (CT), and magnetic resonance imaging. The cohort was divided into 3 groups according to their inclination angles and also grouped as intact-rotator cuff and torn-cuff group. Results The median (min/max) values for the 231 shoulders were 8° (− 23°/56°) for the inclination angle, − 11°(− 55°/23°) for the version angle, and 31.5°(17.6°/61.6°) for the CSA. The majority of the glenoids were found to show posterior-superior erosion. Glenoid inclination angle and CSA were significantly higher in torn-cuff group when compared with intact-cuff group (P < 0.001, both). The rotator cuff tears were statistically significant in high inclination group than low inclination group and no inclination group (p < 0.001). In the high inclination group, 41 of 105 (39%) shoulders had an intact rotator cuff, in about 18% of all shoulders. Conclusion Our findings show that 3D evaluation of glenoid inclination is mandatory for preoperative planning of shoulder replacement in order to properly assess superior inclination and that reverse shoulder arthroplasty may be considered more frequently than as previously expected, even when the rotator cuff is intact. Level of evidence Level III.

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Bone density and its relation to the development of acromial stress fracture following reverse total shoulder arthroplasty

Shoulder & Elbow ◽

10.1177/1758573220949992 ◽

2020 ◽

pp. 175857322094999

Author(s):

Shawn T Yeazell ◽

Jordan Inacio ◽

Ajith Malige ◽

Hannah Dailey ◽

Gregory F Carolan

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Stress Fracture ◽

Bone Mineral ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Region Of Interest ◽

Volumetric Bone Mineral Density ◽

Mineral Density ◽

Computed Tomography Scans

Background Postoperative acromial stress fracture is a troublesome postoperative complication after reverse shoulder arthroplasty. Our study aims to utilize routinely performed preoperative computed tomography scans to identify differences in the material properties of the acromion in patients who did and did not develop a postoperative acromial stress fracture. Methods Treatment records and computed tomography scans for 99 reverse shoulder arthroplasties were collected. Scans were calibrated using a phantom and transferred for post-processing where the acromion, full scapula, and humeral head were isolated. The final segmented model was used to assess acromial volume and volumetric bone mineral density for each region of interest. Results There was no association between age and volumetric bone mineral density in any region of interest (all R2 ≤ 0.048, all p > 0.082). Patients who developed an acromial stress fracture were not significantly different from those who did not in terms of age, acromial volume, or acromial volumetric bone mineral density (all p > 0.559). Patients with known osteoporosis or osteopenia had slightly lower volumetric bone mineral density, but the differences were not significant (all p ≥ 0.072). Conclusion Postoperative acromial fractures following reverse shoulder arthroplasty cannot be predicted by computed tomography-derived volumetric bone mineral density or volume. These mechanical characteristics also do not predictably decrease with age or osteoporosis diagnosis.

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The Robustness of the Gray Level Co-Occurrence Matrices and X-Ray Computed Tomography Method for the Quantification of 3D Mineral Texture

Minerals ◽

10.3390/min10040334 ◽

2020 ◽

Vol 10 (4) ◽

pp. 334

Author(s):

Marcelene Voigt ◽

Jodie A. Miller ◽

Aubrey N. Mainza ◽

Lunga C. Bam ◽

Megan Becker

Keyword(s):

Computed Tomography ◽

Texture Classification ◽

Critical Factor ◽

Texture Features ◽

Gray Level ◽

X Ray ◽

3 Dimensional ◽

X Ray Computed ◽

Basic Link ◽

Tomography Method

Mineral textural quantification methods have become critical in both geosciences and mineral processing as mineral texture is a critical factor contributing to ore variability. However, the lack of objective mineral texture classification has made quantification difficult. The aim of this study is therefore to investigate the robustness of applying the gray level co-occurrence matrices (GLCM) to 3-dimensional (3D) gray scale images measured by X-ray computed tomography (XCT) for the quantification of mineral texture in 3D. The data quality of the GLCM outputs like statistics, heat maps and histograms in response to changes in XCT conditions such as artefacts, resolution, and calibration was tested. The response of the GLCM outputs with respect to different mineral texture types with anisotropic features and inter-sample variability was also explored. The methodology included testing core sizes of 26, 19, 14, and 6 mm diameter. Calibration was tested using copper and tungsten wires. The study demonstrated the versatility of the method for different sample types. Inter-sample calibration and optimal scanning conditions (quality and integrity) were also demonstrated, and a basic link between the 3D GLCM statistical descriptors with the mineral texture features of rocks was established. The 3D mineral texture method can potentially bypass the XCT segmentation process for direct automation of 3D mineral texture information.

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