A CT scan protocol for the detection of radiographic loosening of the glenoid component after total shoulder arthroplasty
The authors suggest that it is difficult to evaluate glenoid component periprosthetic radiolucencies in total shoulder arthroplasties using plain radiographs. This study was performed to evaluate whether computed tomography (CT) using a specific patient position in the CT scanner provides a better method for assessing radiolucencies in TSA.
The protocol almost completely eliminated metal artifacts in the CT images and allowed accurate assessment of periprosthetic lucency of the glenoid fixation.
Interestingly a radiolucent line was identified in 54 of the 55 observed CT scans and osteolysis was identified in 25 observations. The average radiolucent line Molé score was 3.4 points with plain radiographs and 9.5 points with CT scans.
While there is no question that CT scans may provide more detail, we observe that clinically significant lucencies can usually be seen on well done plain films without the additional expense and radiation exposure of a CT scan.
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