These authors sought to determine the incidence in the United States of preoperative three dimensional imaging prior to anatomic total shoulder arthroplasty for osteoarthritis and to determine if preoperative imaging is associated with decreased complication rates.
They used a Medicare insurance database, to identify patients who underwent computed tomography
(n.9380) and/or magnetic resonance imaging (n.15,653) prior to anatomic total shoulder arthroplasty for a diagnosis of osteoarthritis from 2005 to 2014.
The incidence of preoperative three-dimensional imaging significantly increased over time, with computed tomography increasing more than magnetic resonance imaging.
While the overall revision rate was 0.8% lower in the preop CT group, the reasons for the difference are not clear in that the rates of loosening/osteolysis, periprosthetic fracture, periprosthetic disclocation, dislocation/instability, mechanical loosening, implant wear/breakage, and cuff tear were not different between the preop CT group and controls.
Comment: It seems that the clinical benefit 3 dimensional preoperative imaging needs further study with respect to defining its advantages for specific diagnoses.
At present, we find that standardized plain films provide the information needed to plan and perform total shoulder arthroplasty (see this link).
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