Sequential 3-dimensional computed tomography analysis of implant position following total shoulder arthroplasty

Ricchetti, Eric T.; Jun, Bong-Jae; Cain, Richard A.; Youderian, Ari R.; Rodriguez, Eric; Kusin, David J.; Subhas, Naveen; Patterson, Thomas E.; Iannotti, Joseph P.

doi:10.1016/j.jse.2017.12.012

Cited by 19 publications

(45 citation statements)

References 61 publications

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“…Although the risks of radiation exposure are lower in this typically older population than in younger patients, minimizing exposure to radiosensitive organs that are included in the imaged field (e.g., thyroid and breast tissues) is still beneficial. Recent research has shown the value of using CT rather than radiographs to follow patients after arthroplasty [15]. Ricchetti et al [15] found that glenoid component migration can be detected early in the postoperative period on sequential MAR CT scans but not on radiographs.…”

Section: Discussionmentioning

confidence: 99%

“…Tantalum beads were implanted in each of the 3 peripheral pegs of the glenoid component, which were used for automatic detection of the glenoid component position. Patients were selected such that the cohort would contain patients with and without central peg osteolysis of the glenoid component, as defined in a previously published study [15].…”

Section: Aim 2: Qualitative Comparison Of Image Quality On Simulated and Actual Half-dose Scans In Cadaversmentioning

confidence: 99%

“…Implant position was automatically calculated with respect to the scapular coordinate system by detecting the radiopaque tantalum markers that were implanted at the time of surgery. Details of the implant position analysis have been published previously [15][16][17][18]. Fourteen parameters of glenoid position were measured using the simulated half-dose and full-dose images.…”

Section: Aim 3: Quantitative Comparison Of Implant Position On Simulated Half-dose and Full-dose Images In Patientsmentioning

confidence: 99%

“…Osteolysis in the bone adjacent to the glenoid component pegs and atrophy of the rotator cuff muscles were independently evaluated by 2 readers (1 shoulder arthroplasty surgeon and 1 musculoskeletal radiologist), both of whom were blinded to technique. Central peg osteolysis was graded using a 3-point scale as originally described for radiographs [19] and adapted for use in CT [15]. Grade 1 was defined as marked osteolysis around the central peg.…”

Section: Aim 4: Qualitative Comparison Of Image Quality Of Simulated Half-dose and Full-dose Images In Patientsmentioning

confidence: 99%

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Low-dose CT with metal artifact reduction in arthroplasty imaging: a cadaveric and clinical study

et al. 2020

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Objective To determine whether a simulated low-dose metal artifact reduction (MAR) CT technique is comparable with a clinical dose MAR technique for shoulder arthroplasty evaluation. Materials and methods Two shoulder arthroplasties in cadavers and 25 shoulder arthroplasties in patients were scanned using a clinical dose (140 kVp, 300 qrmAs); cadavers were also scanned at half dose (140 kVp, 150 qrmAs). Images were reconstructed using a MAR CT algorithm at full dose and a noise-insertion algorithm simulating 50% dose reduction. For the actual and simulated half-dose cadaver scans, differences in SD for regions of interest were assessed, and streak artifact near the arthroplasty was graded by 3 blinded readers. Simulated half-dose scans were compared with full-dose scans in patients by measuring differences in implant position and by comparing readers' grades of periprosthetic osteolysis and muscle atrophy. Results The mean difference in SD between actual and simulated half-dose methods was 2.42 HU (95% CI [1.4, 3.4]). No differences in streak artifact grades were seen in 13/18 (72.2%) comparisons in cadavers. In patients, differences in implant position measurements were within 1°or 1 mm in 149/150 (99.3%) measurements. The inter-reader agreement rates were nearly identical when readers were using full-dose (77.3% [232/300] for osteolysis and 76.9% [173/225] for muscle atrophy) and simulated half-dose (76.7% [920/1200] for osteolysis and 74.0% [666/900] for muscle atrophy) scans. Conclusion A simulated half-dose MAR CT technique is comparable both quantitatively and qualitatively with a standard-dose technique for shoulder arthroplasty evaluation, demonstrating that this technique could be used to reduce dose in arthroplasty imaging.

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Section: Discussionmentioning

confidence: 99%

Section: Aim 2: Qualitative Comparison Of Image Quality On Simulated and Actual Half-dose Scans In Cadaversmentioning

confidence: 99%

Section: Aim 3: Quantitative Comparison Of Implant Position On Simulated Half-dose and Full-dose Images In Patientsmentioning

confidence: 99%

Section: Aim 4: Qualitative Comparison Of Image Quality Of Simulated Half-dose and Full-dose Images In Patientsmentioning

confidence: 99%

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Low-dose CT with metal artifact reduction in arthroplasty imaging: a cadaveric and clinical study

et al. 2020

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“…A computed tomography (CT) scan has become standard in many surgeons practice to facilitate preoperative planning. Custom patient guides are available from a wide variety of manufacturers to assist with planning and intraoperative placement of components 123). Some surgeons also prefer to have an magnetic resonance imaging to evaluate the soft tissue.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Pearls and Tips in Shoulder Arthroplasty

Sperling

2019

Clin Orthop Surg

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There has been rapid evolution in new techniques and technology in shoulder arthroplasty. This has improved the efficiency of the procedures as well as expanded our ability to manage some of the most challenging cases. This article will review key aspects of patient evaluation, discuss key technical steps in primary anatomic and reverse arthroplasty, and lastly provide tips to facilitate revision surgery.

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Validation of a 3D CT imaging method for quantifying implant migration following anatomic total shoulder arthroplasty

Jun

Ricchetti

Haladik

et al. 2021

Journal Orthopaedic Research

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Glenoid component loosening remains a common complication following anatomic total shoulder arthroplasty (TSA); however, plain radiographs are unable to accurately detect early implant migration. The purpose of this study was to validate the accuracy of a method of postoperative, three-dimensional (3D) computed tomography (CT) imaging with metal artifact reduction (MAR) to detect glenoid component migration following anatomic TSA. Tantalum bead markers were inserted into polyethylene glenoid components for implant detection on 3D CT. In-vitro validation was performed using a glenoid component placed into a scapula sawbone and incrementally translated and rotated, with MAR 3D CT acquired at each test position. Accuracy was evaluated by root mean square error (RMSE). In-vivo validation was performed on six patients who underwent anatomic TSA, with two postoperative CT scans acquired in each patient and marker-based radiostereometric analysis (RSA) performed on the same days. Glenoid component migration was calculated relative to a scapular coordinate system for both MAR 3D CT and RSA. Accuracy was evaluated by RMSE and paired Student's t-tests.The largest RMSE on in-vitro testing was 0.24 mm in translation and 0.11°in rotation, and on in-vivo testing was 0.47 mm in translation and 1.04°in rotation. There were no significant differences between MAR 3D CT and RSA measurement methods. MAR 3D CT imaging is capable of quantifying glenoid component migration with a high level of accuracy. MAR 3D CT imaging is advantageous over RSA because it is readily available clinically and can also be used to evaluate the implant-bone interface.

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Sequential 3-dimensional computed tomography analysis of implant position following total shoulder arthroplasty

Cited by 19 publications

References 61 publications

Low-dose CT with metal artifact reduction in arthroplasty imaging: a cadaveric and clinical study

Low-dose CT with metal artifact reduction in arthroplasty imaging: a cadaveric and clinical study

Pearls and Tips in Shoulder Arthroplasty

Validation of a 3D CT imaging method for quantifying implant migration following anatomic total shoulder arthroplasty

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