The Influence of Three-Dimensional Computed Tomography Images of the Shoulder in Preoperative Planning for Total Shoulder Arthroplasty

2008 ◽  
Vol 90 (11) ◽  
pp. 2438-2445 ◽  
Author(s):  
Jason J Scalise ◽  
Michael J Codsi ◽  
Jason Bryan ◽  
John J Brems ◽  
Joseph P Iannotti
Keyword(s):  
Computed Tomography ◽  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Computed Tomography Images

scholarly journals Immersive 3D virtual reality imaging in planning minimally invasive and complex adult cardiac surgery

2020 ◽  
Vol 1 (1) ◽  
pp. 62-70
Author(s):  
Amir H Sadeghi ◽  
Wouter Bakhuis ◽  
Frank Van Schaagen ◽  
Frans B S Oei ◽  
Jos A Bekkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Virtual Reality ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Preoperative Planning ◽  
Operating Time ◽  
Three Dimensional ◽  
Cardiothoracic Surgery ◽  
Planning Tool ◽  
Computed Tomography Images

Abstract Aims Increased complexity in cardiac surgery over the last decades necessitates more precise preoperative planning to minimize operating time, to limit the risk of complications during surgery and to aim for the best possible patient outcome. Novel, more realistic, and more immersive techniques, such as three-dimensional (3D) virtual reality (VR) could potentially contribute to the preoperative planning phase. This study shows our initial experience on the implementation of immersive VR technology as a complementary research-based imaging tool for preoperative planning in cardiothoracic surgery. In addition, essentials to set up and implement a VR platform are described. Methods Six patients who underwent cardiac surgery at the Erasmus Medical Center, Rotterdam, The Netherlands, between March 2020 and August 2020, were included, based on request by the surgeon and availability of computed tomography images. After 3D VR rendering and 3D segmentation of specific structures, the reconstruction was analysed via a head mount display. All participating surgeons (n = 5) filled out a questionnaire to evaluate the use of VR as preoperative planning tool for surgery. Conclusion Our study demonstrates that immersive 3D VR visualization of anatomy might be beneficial as a supplementary preoperative planning tool for cardiothoracic surgery, and further research on this topic may be considered to implement this innovative tool in daily clinical practice. Lay summary Over the past decades, surgery on the heart and vessels is becoming more and more complex, necessitating more precise and accurate preoperative planning. Nowadays, operative planning is feasible on flat, two-dimensional computer screens, however, requiring a lot of spatial and three-dimensional (3D) thinking of the surgeon. Since immersive 3D virtual reality (VR) is an upcoming imaging technique with promising results in other fields of surgery, we aimed in this study to explore the additional value of this technique in heart surgery. Our surgeons planned six different heart operations by visualizing computed tomography scans with a dedicated VR headset, enabling them to visualize the patient’s anatomy in an immersive and 3D environment. The outcomes of this preliminary study are positive, with a much more reality-like simulation for the surgeon. In such, VR could potentially be beneficial as a preoperative planning tool for complex heart surgery.

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.

scholarly journals Templating in shoulder arthroplasty – A comparison of 2D CT to 3D CT planning software: A systematic review

2019 ◽  
Vol 12 (5) ◽  
pp. 303-314
Author(s):  
Oluwatobi R Olaiya ◽  
Ibrahim Nadeem ◽  
Nolan S Horner ◽  
Asheesh Bedi ◽  
Timothy Leroux ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Computer Software ◽  
3D Ct ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
2D And 3D

Background Computed tomography (CT) utilizing computer software technology to generate three-dimensional (3D) rendering of the glenoid has become the preferred method for preoperative planning. It remains largely unknown what benefits this software may have to the intraoperative placement of the components and patient outcomes. Purpose The purpose of this systematic review is to compare 2D CT to 3D CT planning in total shoulder arthroplasty. Study design Systematic review. Methods A systematic database search was conducted for relevant studies evaluating the role of 3D CT planning in total shoulder arthroplasty. The primary outcome was component placement variability, and the secondary outcomes were intra- and inter-observer reliability in the context of preoperative planning. Results Following title-abstract and full-text screening, six eligible studies were included in the review (n = 237). The variability in glenoid measurements between 3D CT and 2D CT planning ranged from no significant difference to a 5° difference in version and 1.7° difference in inclination (p<0.05). Posterior bone loss was underestimated in 52% of the 2D measured patients relative to 3D CT groups. Irrespective of 2D and 3D planning (39% and 43% of cases respectively), surgeons elected to implant larger components than those templated. There was no literature identified comparing differences in time, cost, functional outcomes, complications, or patient satisfaction. Conclusion The paucity of evidence exploring clinical parameters makes it difficult to comment on clinical outcomes using different methods of templating. More studies are required to identify how improved radiographic outcomes translate into improvements that are clinically meaningful to patients.

Trends and impact of three-dimensional preoperative imaging for anatomic total shoulder arthroplasty

2020 ◽  
pp. 175857322090886
Author(s):  
Jourdan M Cancienne ◽  
Ian J Dempsey ◽  
Grant E Garrigues ◽  
Brian J Cole ◽  
Stephen F Brockmeier ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Preoperative Imaging ◽  
Complication Rates ◽  
Resonance Imaging ◽  
Computed Tomography Imaging ◽  
Three Dimensional Imaging ◽  
Tomography Imaging

Background The goals of this study were to determine the incidence in the United States of preoperative three-dimensional imaging prior to anatomic total shoulder arthroplasty for osteoarthritis and to determine if preoperative imaging is associated with decreased complication rates. Methods Using a Medicare insurance database, we identified all patients who underwent computed tomography (n = 9380) and/or magnetic resonance imaging (n = 15,653) prior to anatomic total shoulder arthroplasty for a diagnosis of osteoarthritis from 2005 to 2014. The incidence of imaging over time was analyzed and complication rates compared between patients with imaging to matched controls. Results The incidence of preoperative three-dimensional imaging significantly increased over time, with computed tomography increasing more than magnetic resonance imaging. Compared to controls, patients with preoperative computed tomography imaging had significantly lower revision rates at two years (odds ratio 0.72 (0.64–0.82), p = 0.008). There were no other significant differences in the other complications studied. Conclusions The use of preoperative three-dimensional imaging for anatomic total shoulder arthroplasty for a diagnosis of osteoarthritis has increased dramatically, with the use of computed tomography increasing the most. Patients who underwent preoperative computed tomography imaging experienced lower revision rates at two years postoperatively compared to matched controls without such imaging. Level of evidence Level III, retrospective comparative study.

Total Wrist Arthroplasty Alignment and Its Potential Association with Clinical Outcomes

2021 ◽  
Author(s):  
Bardiya Akhbari ◽  
Kalpit N. Shah ◽  
Amy M. Morton ◽  
Janine Molino ◽  
Douglas C. Moore ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Outcomes ◽  
Three Dimensional ◽  
Radial Component ◽  
Single Type ◽  
Radiographic Images ◽  
Computed Tomography Images ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Wrist Arthroplasty

Abstract Purpose There is a lack of quantitative research that describes the alignment and, more importantly, the effects of malalignment on total wrist arthroplasty (TWA). The main goal of this pilot study was to assess the alignment of TWA components in radiographic images and compare them with measures computed by three-dimensional analysis. Using these measures, we then determined if malalignment is associated with range of motion (ROM) or clinical outcomes (PRWHE, PROMIS, QuickDash, and grip strength). Methods Six osteoarthritic patients with a single type of TWA were recruited. Radiographic images, computed tomography images, and clinical outcomes of the wrists were recorded. Using posteroanterior and lateral radiographs, alignment measurements were defined for the radial and carpal components. Radiographic measurements were validated with models reconstructed from computed tomography images using Bland–Altman analysis. Biplanar videoradiography (<1mm and <1 degree accuracy) was used to capture and compute ROM of the TWA components. Linear regression assessed the associations between alignment and outcomes. Results Radiographic measures had a 95% limit-of-agreement (mean difference ±  1.96 × SD) of 3 degrees and 3mm with three-dimensional values, except for the measures of the carpal component in the lateral view. In our small cohort, wrist flexion–extension and radial–ulnar deviation were correlated with volar–dorsal tilt and volar–dorsal offset of the radial component and demonstrated a ROM increase of 3.7 and 1.6 degrees per degree increase in volar tilt, and 10.8 and 4.2 degrees per every millimeter increase in volar offset. The carpal component's higher volar tilt was also associated with improvements in patient-reported pain. Conclusions We determined metrics describing the alignment of TWA, and found the volar tilt and volar offset of the radial component could potentially influence the replaced wrist's ROM. Clinical Relevance TWA component alignment can be measured reliably in radiographs, and may be associated with clinical outcomes. Future studies must evaluate its role in a larger cohort.

scholarly journals Three-dimensional assessment of the anterior and inferior loop of the inferior alveolar nerve using computed tomography images in patients with and without mandibular asymmetry

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae-Young Kim ◽  
Michael D. Han ◽  
Kug Jin Jeon ◽  
Jong-Ki Huh ◽  
Kwang-Ho Park
Keyword(s):  
Computed Tomography ◽  
Symmetry Group ◽  
Three Dimensional ◽  
Inferior Alveolar Nerve ◽  
Mental Foramen ◽  
3D Analysis ◽  
Mandibular Asymmetry ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Mandibular Body

Abstract Background The purpose of this study was to investigate the differences in configuration and dimensions of the anterior loop of the inferior alveolar nerve (ALIAN) in patients with and without mandibular asymmetry. Method Preoperative computed tomography images of patients who had undergone orthognathic surgery from January 2016 to December 2018 at a single institution were analyzed. Subjects were classified into two groups as “Asymmetry group” and “Symmetry group”. The distance from the most anterior and most inferior points of the ALIAN (IANant and IANinf) to the vertical and horizontal reference planes were measured (dAnt and dInf). The distance from IANant and IANinf to the mental foramen were also calculated (dAnt_MF and dInf_MF). The length of the mandibular body and symphysis area were measured. All measurements were analyzed using 3D analysis software. Results There were 57 total eligible subjects. In the Asymmetry group, dAnt and dAnt_MF on the non-deviated side were significantly longer than the deviated side (p < 0.001). dInf_MF on the non-deviated side was also significantly longer than the deviated side (p = 0.001). Mandibular body length was significantly longer on the non-deviated side (p < 0.001). There was no significant difference in length in the symphysis area (p = 0.623). In the Symmetry group, there was no difference between the left and right sides for all variables. Conclusion In asymmetric patients, there is a difference tendency in the ALIAN between the deviated and non-deviated sides. In patients with mandibular asymmetry, this should be considered during surgery in the anterior mandible.

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