Shoulder arthroplasty

Abstract

Shoulder prostheses are now commonly used. Clinical results and patient satisfaction are usually good. The most commonly used types are humeral hemiarthroplasty, unconstrained total shoulder arthroplasty, and semiconstrained inversed shoulder prosthesis. Complications of shoulder arthroplasty depend on the prosthesis type used. The most common complications are prosthetic loosening, glenohumeral instability, periprosthetic fracture, rotator cuff tears, nerve injury, infection, and deltoid muscle dysfunction. Standard radiographs are the basis of both pre- and postoperative imaging. Skeletal scintigraphy has a rather limited role because there is overlap between postoperative changes which may persist for up to 1 year and early loosening and infection. Sonography is most commonly used postoperatively in order to demonstrate complications (hematoma and abscess formation) but may also be useful for the demonstration of rotator cuff tears occurring during follow-up. CT is useful for the demonstration of bone details both pre- and postoperatively. MR imaging is mainly used preoperatively, for instance for demonstration of rotator cuff tears.

Metal artefact reduction in gemstone spectral imaging dual-energy CT with and without metal artefact reduction software

“…Plain radiography is a traditional imaging method for arthroplasty failure but it has low sensitivity and specificity [5,6]. Arthrography can be used for detection of loosening The real size of the thickness/hole diameter of stainless steel and titanium were 18/6 and 15/6 mm, respectively which is shown as leakage of contrast material around the prosthesis [7].…”

“…Alternatives are thought to be either CT or magnetic resonance imaging (MRI) in spite of troubling metal-related artefacts [9]. The degree of metallic artefacts depends on the thickness, density, orientation and geometry of the prosthesis and CT parameters including tube voltage, tube current and collimation [6,10]. New CT technologies provide thinner slices, higher kVp or mAs, and a better reconstruction algorithm so that image quality can be improved [10][11][12][13][14][15].…”

Comparative analysis of anatomic and reverse total shoulder arthroplasty: in-hospital outcomes and costs

“…Since 2004, total shoulder arthroplasty (TSA) has increased by approximately 3000 cases each year in the United States compared with an annual increase of fewer than 400 cases each year prior. 30 This trend is expected to continue 15 and is likely due to a multitude of factors, including improved implant design and surgical technique, 9 increased density of shoulder and elbow specialists, expanding elderly population, and Food and Drug Administration approval of reverse total shoulder arthroplasty (RTSA) in November 2003. 30 Anatomic total shoulder arthroplasty (ATSA) is frequently employed as a treatment modality for patients with symptomatic degenerative glenohumeral joint disease with an intact rotator cuff and maintained glenoid.…”

Imaging Algorithms for Evaluating Suspected Rotator Cuff Disease: Society of Radiologists in Ultrasound Consensus Conference Statement

“…A review of serial radiographs postoperatively is also crucial to the differentiation of stable radiolucent lines from findings of loosening, implant subsidence, or osteolysis. US has been shown to be very accurate in the evaluation of the rotator cuff in patients who have undergone arthroplasty (45,46). Only if the US scan is equivocal would another test be necessary.…”

“…Panelists agreed that patients with shoulder pain after arthroplasty should undergo both radiography and US in all circumstances unless an obvious radiographic finding such as a fracture or prosthetic loosening obviates the need for further imaging (45). A review of serial radiographs postoperatively is also crucial to the differentiation of stable radiolucent lines from findings of loosening, implant subsidence, or osteolysis.…”