Hill–Sachs lesion measurement with tridimensional models in anterior shoulder instability

Abstract

ObjectiveTo evaluate the reproducibility and repeatability of Hill–Sachs lesion measurement from computed tomography images, with computer software and tridimensional prototype.MethodsThree-dimensional models were made from computed tomography images from 14 patients with anterior shoulder instability, using InVesalius 3.0® software. Hill–Sachs lesions were measured with Rhinocerus 5.0® software with pre-determined position. Mid-lateral distance, perpendicular to humeral shaft, cranial-caudal distance, parallel to humeral shaft, and the longitudinal distance of the lesion were measured. Using the Printer-ZP 310 three-dimensional printer, plaster models were made. To measure the Hill–Sachs lesion, a calibrated universal digital caliper was used in the same way as the software.ResultsThere was intra-observer and inter-observer variability for measurement of the same model. Observers did not perform the measurements in a similar way, showing difficulty to use the method (p < 0.05). Using the software to measure the mid-lateral distance, as well as in the measurement with the caliper, the model type influenced the measurements for each of the observers, rendering the method invalid (p < 0.05).ConclusionThere was no reproducibility and repeatability for Hill–Sachs lesion measurement between plaster models and software models.

Validação clínica do conceito de glenoid track na instabilidade glenoumeral anterior

“…Bone loss of the humerus head was measured in axial slice, from the linear distance of the joint insertion of the rotator cuff to the medial margin of the Hill-Sachs lesion. 14 Axial slice with the largest Hill-Sachs lesion was used to measure the Hill-Sachs interval 14 18 19 ( Figure 1 ). The evaluation of the glenoid was performed using a more lateral T1-weighted oblique sagittal slice that included the glenoid.…”

“…A perda óssea da cabeça do úmero foi medida em corte axial, a partir da distância linear da inserção articular do manguito rotador à margem medial da lesão de Hill-Sachs. 14 O corte axial com a maior lesão de Hill-Sachs foi utilizado para a mensuração do intervalo de Hill-Sachs 14 18 19 ( Figura 1 ). A avaliação da cavidade glenoidal foi realizada usando o corte sagital oblíquo ponderado em T1 mais lateral, que incluía a cavidade glenoidal.…”

3D printing in shoulder surgery

“…In contrast, Miyazaki et al , 36 after producing 3D plaster models of Hill Sachs lesion obtained from CT scan of 14 patients with anterior shoulder instability, showed that there was no reliability for Hill-Sachs lesion measurements between plaster models and software models, thus arguing that a different method to assess the Hill Sachs lesion is still required.…”

“…In contrast, Miyazaki et al, 36 after producing 3D plaster models of Hill Sachs lesion obtained from CT scan of 14 patients with anterior shoulder instability, showed that there was no reliability for Hill-Sachs lesion measurements between plaster models and software models, thus arguing that a different method to assess the Hill Sachs lesion is still required. 3D printing in orthopedic traumatology 3D printing technology can find various application in the field of orthopaedic trauma; it provides a dynamic integration of digital industry technology and modern minimally invasive technology for orthopaedics.…”

“…There are only a few studies documenting the use of 3D printing technology on the treatment of recurrent anterior shoulder instability in literature. [34][35][36] They all agree on the fact that the use of 3D printing can have several advantages: enhancing the understanding of depth and size of bony lesions, thus allowing a patient tailored surgical planning and potentially reduce the operative times, 34 and the possible complications; allowing the production of personalized implants to restore substantial glenoid bone loss as well as glenohumeral morphology and bone stability. Sheth et al, 34 in 2015, presented the case of a 29 year old man with a history of recurrent anterior shoulder dislocations, that had over 20 traumatic and atraumatic episodes of anterior dislocation or subluxation.…”