AI Article Synopsis
- The study compares the effectiveness of 3-D CT volumetric filling ratio (VFR) versus plain radiographs in predicting stress shielding after short-stem anatomic total shoulder arthroplasty (aTSA).
- A total of 44 patients were analyzed, and those with stress shielding exhibited significantly higher 3-D VFR compared to those without, indicating the superiority of the 3-D method.
- The 3-D VFR demonstrated a high predictive accuracy of 92%, suggesting it can help identify at-risk patients and enhance the design of humeral stems.
Article Abstract
Introduction: Three-dimensional (3-D) CT volumetric filling ratio (VFR) is a better predictor of proximal humerus stress shielding after short-stem anatomic total shoulder arthroplasty (aTSA) than using plain radiographs.
Methods: Forty-four patients with short-stem aTSAs, preoperative CT scans, and a minimum 3-year radiographic follow-up were included. Patients were divided into group A (stress shielding) and group B (no stress shielding) based on the radiographic analysis. Standard implant filling ratios were measured on plain radiographs. The 3-D VFR of the metaphyseal and diaphyseal segments of the aTSA stem was measured using MIMICS (Materialise). The area under a receiver operator characteristic curve was used to determine the predictive strength of the 3-D VFR method.
Results: The average age and radiographic follow-up was 69 years and 44 months. Group A had 19 patients and statistically higher filling ratios using 3-D VFR method than group B, whereas no notable differences were found between the groups using standard techniques. The 3-D VFR had an area under a receiver operator characteristic curve of 92%, which supports it as a good predictor of stress shielding.
Conclusions: These methods enable early identification of patients at risk for stress shielding and can also be valuable in improving humeral stem designs.
Level Of Evidence: Level III. Case-control study.
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| http://dx.doi.org/10.5435/JAAOS-D-19-00444 | DOI Listing |
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