Friday, September 9, 2016

Does a preoperative CT show the key information about the arthritic shoulder?

Here is the preoperative AP view of the right shoulder of a 43 year old man with arthritis after a prior labral repair and acromioplasty.

His 'truth view' (axillary view with the arm in the functional position of elevation in the plane of the scapula) shows posterior decentering of the humeral head on the glenoid.
 He came to see us having had a prior CT scan, which, interestingly, did not show this functional decentering.

Our practice is to base our surgical decision making on the preoperative AP and 'truth view' (see this link) and avoid the cost and radiation exposure of a CT scan.

At his ream and run surgery his tendency for posterior decentering was managed with an anteriorly eccentric humeral component.

Here are his films at one year.