Reliability of Implant- vs. Bone-Based Postoperative Measurements After Anatomic Total Shoulder Arthroplasty Using CT Imaging

IF 2.4 3区医学 Q2 ORTHOPEDICS

Journal of Orthopaedic Research® Pub Date : 2026-10-10 DOI:10.1002/jor.70292

Nazanin Daneshvarhashjin, Philippe Debeer, Filip Verhaegen, Lennart Scheys

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引用次数: 0

Abstract

In anatomic total shoulder arthroplasty (aTSA) research, postoperative anatomical measurements are often referenced to the reamed glenoid bone surface because the glenoid component is not fully visible on CT. However, the reliability of measurements based directly on the implant (implant-based method) and their agreement with the commonly used bone-based method remain unclear. In this study, CT scans from 29 patients undergoing primary aTSA were used to calculate postoperative glenoid positioning (translations, version, inclination) and HHS in the anterior–posterior (HHS_AP) and superior–inferior (HHS_SI) directions using both methods. The bone-based method referenced measurements to 3D postoperative scapular bone reconstructions, whereas the implant-based method used CT-registered digital glenoid component models. Inter- and intra-rater reliability of implant-based measurements were assessed using intraclass correlation coefficients (ICCs), and agreement between methods was evaluated using ICCs and Bland–Altman analyses. The implant-based approach demonstrated high inter- and intra-rater reliability (ICCs > 0.88), with minimal detectable changes below commonly cited clinical thresholds. The agreement between implant- and bone-based methods was moderate-to-excellent overall (ICC > 0.52), although significant bias and/or wide limits of agreement were observed for version, inclination, superior-inferior implant positioning, and HHS_SI. Compared to implant-based measures, bone-based estimates showed a bias toward more superior implant positioning and superior HHS_SI, greater retroversion, and more medialized implant positioning. In conclusion, direct implant-to-CT registration is a reliable method for 3D postoperative measurements after aTSA. Implant- and bone–based measurements can be used interchangeably for anterior–posterior implant positioning and HHS_AP, but not for other measures when high precision is required.

Level of Evidence

Basic science study.

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解剖性全肩关节置换术后植入物与骨术后测量的CT成像可靠性

在解剖性全肩关节置换术（aTSA）研究中，术后解剖测量通常参考扩眼盂骨表面，因为盂骨部分在CT上不能完全可见。然而，直接基于种植体（基于种植体的方法）测量的可靠性及其与常用的基于骨的方法的一致性仍不清楚。在本研究中，使用29例接受原发性aTSA的患者的CT扫描，使用两种方法计算术后关节盂定位（平移、变形、倾斜）和前后（HHSAP）和上下（HHSSI）方向的HHS。基于骨的方法参考了三维术后肩胛骨重建的测量结果，而基于植入物的方法使用了ct注册的数字肩关节构件模型。采用类内相关系数（ICCs）评估基于植入物测量的组间和组内可靠性，并采用ICCs和Bland-Altman分析评估方法之间的一致性。基于植入物的方法显示出较高的评分间和评分内可靠性（ICCs > 0.88），最小的可检测变化低于常用的临床阈值。种植体和骨为基础的方法之间的一致性总体上是中等到优秀的（ICC > 0.52），尽管在版本、倾斜度、种植体的优劣定位和HHSSI方面观察到显著的偏差和/或广泛的一致性限制。与基于种植体的测量相比，基于骨的估计显示更优越的种植体定位和更优越的HHSSI，更大的后倾和更中等的种植体定位。总之，直接植入物- ct配准是aTSA术后三维测量的可靠方法。种植体和骨为基础的测量可以互换用于前后路种植体定位和HHSAP，但当需要高精度时，不能用于其他测量。证据水平基础科学研究。

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

Journal of Orthopaedic Research® 医学-整形外科

CiteScore

6.10

自引率

3.60%

发文量

261

审稿时长

3-6 weeks

期刊介绍： The Journal of Orthopaedic Research is the forum for the rapid publication of high quality reports of new information on the full spectrum of orthopaedic research, including life sciences, engineering, translational, and clinical studies.