Variability of measurement of glenoid version on computed tomography scan

Bokor, Desmond J.; O’Sullivan, Michael; Hazan, Georges J

doi:10.1016/s1058-2746(99)90096-4

Cited by 161 publications

(122 citation statements)

References 5 publications

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“…The first studies which focus on intra-and inter-reliability have shown unsatisfactory precision of measurement of radiographic parameters used to quantify a glenoid retroversion [9,10]. The low reproducibility of X-ray evaluation results from great variation in scapular positioning, which affects identification of homological points on this bone [11,12]. Nevertheless, radiographic imaging is still widely used in shoulder instability to assess the presence or absence of bony abnormalities, fractures, Hill-Sachs lesion or any other pathologic changes in the joint [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Kubicka

Stefaniak

Lubiatowski

et al. 2016

International Orthopaedics (SICOT)

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Purpose The main purpose of this study is to establish which of two methods is more reliable in glenoid assessment for instability in pre-operative planning. Accordingly, we have studied the intra-and inter-observer reliability of glenoid parameters with the use of two-dimensional (2D) and three-dimensional (3D) reconstructed computed tomography (CT) images. Methods One hundred glenoids were measured with the use of 2D-CT and 3D-CT (in 3D orientation) by two independent observers (one experienced and one inexperienced). Measurements were repeated after one week for 30 randomly selected glenoids. Results The intra-class correlation coefficient (ICC) for interobserver reliability was significantly greater for 3D-CT (0.811 to 0.915) than for 2D-CT (0.523 to 0.925). All intra-observer reliability values for 3D-CT were near perfect (0.835 to 0.997), while those for 2D-CT were less reliable (0.704 to 0.960). A dependent t-test showed that, for both observers, almost all glenoid parameters (except R and d) differed significantly (p < 0.05) between 2D and 3D measurement methods. Conclusions Therefore, it can be concluded that 3D glenoid reconstructions are more reliable for glenoid bone loss assessment than 2D-CT. The results suggest that quantifying a glenoid defect with the use of 2D image only-even if performed by an experienced orthopaedic surgeon-is prone to errors. Differences in measurements between and within observers can be explained by plane setting and identifying glenoid rim in 2D -C T. Accordingly, we recommend that glenoid measurements should be performed in 3D orientation using 3D reconstruction obtained from CT images for pre-operative assessments, which are crucial for surgical planning.

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Section: Introductionmentioning

confidence: 99%

Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Kubicka

Stefaniak

Lubiatowski

et al. 2016

International Orthopaedics (SICOT)

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“…Current preoperative CT measurement techniques for glenoid orientation [3] are subject to rotational errors due to non-standardized patient positioning techniques during image acquisition [16]. These unaccounted changes in rotation or inclination of the scapula can change the measured version on the chosen CT axial slice [16].…”

Section: Discussionmentioning

confidence: 99%

“…These unaccounted changes in rotation or inclination of the scapula can change the measured version on the chosen CT axial slice [16]. The unknown scapular orientation during CT makes it difficult to obtain an accurate version measurement on the chosen CT axial slice, which can lead to improper intraoperative placement of the glenoid component.…”

Section: Discussionmentioning

confidence: 99%

“…CAGI also allows for preoperative templating of the final position of the glenoid component, and can help the surgeon decide on the optimal orientation of the implant. This standardized protocol removes the user variability involved in estimating scapular rotation, which affects the measurement of the true glenoid version [16]. This error could potentially be reduced by the use of more precise instruments, better registration and calibration techniques.…”

Section: Discussionmentioning

confidence: 99%

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Design and development of a computer assisted glenoid implantation technique for shoulder replacement surgery

Nguyen

Ferreira

Brownhill

et al. 2007

Computer Aided Surgery

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Objective: Replacement of the diseased shoulder joint with implants is a procedure whose frequency is rapidly increasing. However, glenoid replacement remains challenging due to the difficult joint exposure and visualization of anatomical reference landmarks during the procedure. Improper positioning of the glenoid component can lead to early failure. The objective of this study was to develop and evaluate a Computer Assisted Glenoid Implantation (CAGI) technique to achieve a more accurate and reliable placement of the glenoid component. Materials and Methods: Twenty cadaveric scapulae were imaged with CT. The accuracy of an electromagnetic tracking system and 3D surface modeling for the measurement of glenoid position was compared to that of the standard CT-based method. Custom jigs were then developed to track instruments and to correct for scapular motion during in vitro trials. A standardized protocol for determining, in real time, the glenoid position and placement was developed and validated. Results: The version angles measured by the tracking system, CT, and the 3D modeling software were 0.0 AE 1.2 , -1.3 AE 1.0 , and -1.1 AE 1.1 , respectively. The magnitudes for inclination angles were 0.7 AE 0.7 , 0.9 AE 0.8 , and 1.0 AE 0.7 , respectively. A statistically significant difference was found only between measurements made with the tracking system and with CT (p < 0.05). Testing of the CAGI system in a cadaveric trial resulted in an accuracy of 1.17 of version and 0.60 of inclination. The procedure was readily performed with excellent feedback and guidance for the surgeon. Conclusions: Preoperative planning using CT imaging with 3D modeling and intraoperative tracking were combined to produce improved accuracy and reliability of glenoid implantation in the setting of total shoulder arthroplasty.

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“…We routinely reformat scans into three dimensions along the plane of the scapula. This decreases measurement error due to variations in the plane of image acquisition (gantry angle) [15,16]. The anterior glenoid is a critical landmark for determining the native version, inclination, and joint line position of the B2 glenoid, as it represents the preserved premorbid anatomy that the pathologic glenoid should be corrected back to (Fig.…”

Section: Preoperative Planning and Intraoperative Techniquesmentioning

confidence: 99%

Surgical management of the biconcave (B2) glenoid

Donohue

Ricchetti

Iannotti

2016

Curr Rev Musculoskelet Med

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Glenohumeral osteoarthritis produces a wide spectrum of glenoid pathology. The B2 glenoid is defined by asymmetric posterior bone loss with the development of a biconcavity and posterior translation of the humeral head. Progressive bone loss results in increasing glenoid retroversion, which must be corrected during anatomic shoulder arthroplasty. The goals of arthroplasty should also include centering the humeral head and restoring the normal glenoid joint line. When there is minimal bone loss, this may be accomplished with a standard glenoid component and asymmetric reaming. More significant bone loss requires bone grafting or the use of an augmented glenoid component. Reverse shoulder arthroplasty is also an option for older patients or patients with severe bone loss.

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Variability of measurement of glenoid version on computed tomography scan

Cited by 161 publications

References 5 publications

Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Design and development of a computer assisted glenoid implantation technique for shoulder replacement surgery

Surgical management of the biconcave (B2) glenoid

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