AI Article Synopsis
- The study examines the accuracy of measuring glenoid version in patients with arthritis using 2D and 3D CT images, emphasizing that 2D measurements can often lead to significant errors.
- The results show an average error of 5.1 degrees in glenoid version from 2D images, and critical areas of wear were frequently missed in these slices.
- The findings suggest that to ensure correct assessment and surgical correction in arthritic glenoids, a comprehensive analysis using 3D CT reconstructions is necessary.
Article Abstract
Background/hypothesis: The arthritic glenoid is typically in retroversion and restoration to neutral version is recommended. While a method for measurement of glenoid version using axial computed tomography (CT) has been reported and has been widely accepted, its accuracy and reproducibility has not been established.
Methods: In 33 patients scheduled for shoulder arthroplasty, glenoid version and maximum wear of the glenoid articular surface were measured with respect to the scapular body axis on 2-dimensional- (2D) CT slices as well as on 3-dimensional- (3D) reconstructed models of the same CT slices.
Results: Clinical CT scans were axially aligned with the patient's torso but were almost never perpendicular to the scapular body. The average absolute error in version measured on the 2D-CT slice passing through the tip of the coracoid was 5.1 degrees (range, 0 - 16 degrees , P < .001). On high-resolution 3D-CT reconstructions, the location of maximum wear was most commonly posterior and was missed on the clinical 2D-CT slices in 52% of cases.
Conclusion: Error in measuring version and depth of maximum wear can substantially affect the determination of the degree of correction necessary in arthritic glenoids. Accurately measuring glenoid version and locating the direction of maximum wear requires a full 3D-CT reconstruction and analysis.
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| http://dx.doi.org/10.1016/j.jse.2009.08.009 | DOI Listing |
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Article Synopsis
- The optimal treatment for B2 glenoid morphology in young, active osteoarthritis patients is debated, with various options like hemiarthroplasty, total shoulder arthroplasty (TSA), and reverse TSA available, each having pros and cons.
- Eccentric glenoid reaming can be effective but risks damaging the bone structure, potentially complicating future surgeries, while bone grafting, though beneficial for some, comes with high complication rates.
- Reverse TSA offers a more stable alternative when correcting version and inclination proves difficult, as it adapts better to glenoid deformities and maintains functionality with reduced bone stock.
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