Pre-operative planning for reverse shoulder arthroplasty in low-resource centres: A modified Delphi study in South Africa.

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2024-01-01 Epub Date: 2024-05-30 DOI:10.1051/sicotj/2024021
Pududu Archie Rachuene, Roopam Dey, Ntambue Jimmy Kauta, Sudesh Sivarasu, Jean-Pierre du Plessis, Stephen Roche, Basil Vrettos
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引用次数: 0

Abstract

Background: Pre-operative planning for reverse shoulder arthroplasty (RSA) poses challenges, particularly when dealing with glenoid bone loss. This modified Delphi study aimed to assess expert consensus on RSA planning processes and rationale, specifically targeting low-resourced institutions. Our objective was to offer pre-operative decision-making algorithms tailored for surgeons practising in resource-constrained hospitals with limited access to computed tomography (CT) scans.

Methods: A working group generated statements on pre-operative imaging and glenoid of glenoid morphology and intra-operative decision-making. The study was conducted in three stages, with virtual consensus meetings in between. Stages 2 and 3 consisted only of closed questions/statements. The statements with over 70% were considered consensus achieved and those with less than 10% were considered disagreement consensus achieved.

Results: Twelve shoulder surgeons participated, with 67% having over five years of experience in shoulder arthroplasty. In the absence of glenoid bone loss, the sole use of plain radiographs for pre-operative planning reached consensus and is recommended by these groups, while 100% advise using CT scans when bone loss is present. Most surgeons (70%) recommend using patient-specific instrumentation (PSI) in cases of structural bone loss. Most of the statements on intra-operative decision-making related to component placement and enhancing stability failed to reach consensus.

Conclusion: While consensus was achieved on most aspects of pre-operative imaging and planning, technical aspects of surgery lacked consensus. Planning for patients with structural glenoid bone loss necessitates CT scans and planning tools.

低资源中心反向肩关节置换术的术前规划:南非改良德尔菲研究。
背景:反向肩关节置换术(RSA)的术前规划是一项挑战,尤其是在处理盂骨缺失时。这项修改后的德尔菲研究旨在评估专家对RSA规划流程和原理的共识,特别是针对资源匮乏的机构。我们的目标是为在资源有限、无法获得计算机断层扫描(CT)的医院执业的外科医生提供量身定制的术前决策算法:方法:一个工作组就术前成像、髋臼形态和术中决策制定了声明。研究分三个阶段进行,中间召开虚拟共识会议。第二和第三阶段仅包括封闭式问题/声明。70%以上的陈述被认为达成了共识,10%以下的陈述被认为达成了分歧共识:12名肩关节外科医生参加了此次会议,其中67%的外科医生拥有5年以上的肩关节置换术经验。在没有盂骨缺损的情况下,仅使用普通X光片进行术前规划已达成共识,并得到这些团体的推荐,而在存在骨缺损的情况下,100%的人建议使用CT扫描。大多数外科医生(70%)建议在出现结构性骨缺失时使用患者专用器械(PSI)。大多数关于术中决策的声明都与组件置入和增强稳定性有关,但未能达成共识:结论:虽然在术前成像和规划的大多数方面达成了共识,但在手术的技术方面却缺乏共识。对结构性盂骨缺失患者进行手术规划需要CT扫描和规划工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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