Post-operative Baseplate Radiographic Evaluation Using Routine pre-Operative CT

Daniel J Song, Nathan S Lanham, Rifat Ahmed, Michael L Knudsen, William N Levine, Charles M Jobin
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Abstract

Background There is limited data evaluating post-operative component position and fixation in reverse shoulder arthroplasty (RSA). Therefore, the purpose of this study was to evaluate baseplate position and fixation using routine pre-operative CT and post-operative radiographs. Methods A retrospective analysis of a series consecutive patient who underwent primary RSA was performed. Pre-operative and post-operative glenoid retroversion and inclination were measured using radiographs aligned with projection silhouettes of 3D scapula models in Mimics software. Baseplate retroversion and inclination were measured followed by evaluating for the presence of radiolucent lines (RLLs). Results Twenty-four patients met inclusion criteria. The average age was 73.4 ± 10.7 years (range, 45-89 years). Radiographic follow-up was 3.4 ± 1.3 years. Post-operative glenoid baseplate retroversion was 2 ± 10 degrees (range, 30 to −9). Post-operative glenoid baseplate inclination was 3.8 ± 9.1 (range, −13 to 19). Five (21%) RSAs had baseplate retroversion >10 degrees. Follow-up radiographs revealed no RLLs around the baseplate, central post, or peripheral screws in any patient. Conclusions Pre-operative CT imaging enabled evaluation of baseplate component placement and fixation on post-operative radiographs. Baseplate version was within 10 degrees of neutral in 79% (19/24) of patients. No RLLs or loss of fixation were found in any cases. Level of Evidence Level IV: Diagnostic Study.
术前常规CT的术后基底片评价
背景:目前评价逆行肩关节置换术(RSA)中假体位置和固定的资料有限。因此,本研究的目的是通过常规术前CT和术后x线片评估钢板的位置和固定。方法回顾性分析1例连续行原发性RSA手术的患者。在Mimics软件中,使用与三维肩胛骨模型投影轮廓对齐的x线片测量术前和术后肩关节的后倾和倾斜。测量底板的后倾和倾斜,然后评估放射光线(rll)的存在。结果24例患者符合纳入标准。平均年龄73.4±10.7岁(45 ~ 89岁)。影像学随访3.4±1.3年。术后关节盂底板后倾2±10度(范围:30至−9度)。术后关节盂底板倾角为3.8±9.1(范围:- 13 ~ 19)。5例(21%)rsa的底板后移10度。随访x线片显示,所有患者的底板、中心柱或外周螺钉周围均无rls。结论术前CT成像可以在术后x线片上评估底板构件的放置和固定情况。79%(19/24)患者的底板版本在中性10度以内。所有病例均未发现rll或固定丢失。证据等级IV级:诊断性研究。
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