Friday, January 31, 2020

Glenoid version before and after arthroplasty.

Determining glenoid component version after total shoulder arthroplasty

These authors examined the issue of measuring postoperative glenoid version, pointing out that postoperative CT scans add cost and radiation exposure (of course preoperative CT scans also add cost and radiation exposure as well).

They present a method for assessing glenoid component version after TSA using preoperative CT and postoperative plain radiographs.

Preoperative glenoid version was measured using established methods with an axillary x-ray, 2-dimensional CT, and Glenosys software. 

Postoperative glenoid component version and inclination were measured using Mimics software with preoperative CT and postoperative x-rays. 

It is interesting to see how closely the values for retroversion obtained with axillary x-rays correlated with those obtained using various CT-based methods

Similarly the preoperative to postoperative change in glenoid version was similar with the different methods of preoperative measurement.

The authors point out that the Mimics protocol requires purchase of specialized software, becoming proficient in software 3D modeling, and approximately 30 minutes spent on each patient’s evaluation and analysis due to a lack of specific programming to automate the protocol.

Comment: In an effort to carry out side-by-side comparison of preoperative and and postoperative glenoid version in a practical manner without the added cost and radiation of CT scans, it seems to make the most sense to use standardized axillary views taken in a functional position of elevation in the plane of the scapula

Here are two preop-post op comparisons. Note the standardization of portion and projection.

As for "correcting" preoperative glenoid version, it may not be as important as once thought, click on this reference:

To see a YouTube of our technique for total shoulder arthroplasty, click on this link.

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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You may be interested in some of our most visited web pages arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'