Pasteur Private Hospital, 29200 Brest, France.
Orthop Traumatol Surg Res. 2012 Oct;98(6 Suppl):S139-45. doi: 10.1016/j.otsr.2012.06.007. Epub 2012 Sep 7.
Glenoid component loosening is the main complication of total shoulder arthroplasty. Better knowledge of the arthritic glenoid cavity anatomy can help in developing new implants and techniques. The goal of this study was to describe and validate the reproducibility of a CT scan-based, 3D measurement method used to describe various parameters characterizing arthritic glenoid cavity morphology.
Twelve CT scans and 29 CT arthrogram were evaluated. These scans were taken from 41 patients with glenohumeral osteoarthritis who received an anatomical shoulder prosthesis. A 3D reconstruction of the scapula was performed based on the DICOM files. Following the 3D volume acquisition, points on the glenoid articular surface were manually extracted by three observers, each one three times, allowing one week between readings, to determine the inter- and intra-observer reproducibility. The intraclass correlation coefficient (ICC) was calculated on five 3D parameters that were automatically calculated: glenoïd height, glenoid width, height at maximum width glenoid version and radius of the articular surface best-fit sphere.
The intra-observer and inter-observer ICC were 0.91 to 0.99, and 0.95 to 0.99, respectively.
This study is the first to report on a reproducible 3D measurement method, based on CT scans, for the arthritic glenoid cavity, which derives the joint radius of curvature among other morphology parameters. These 3D measurements are advantageous because they are free of problems related to patient positioning in the CT scanner and to the choice of slices, which limits the accuracy of measurements made on slices from 2D CT scans. Three-dimensional methodology similar to ours has been validated on healthy glenoids.
This study confirms the reliability and good reproducibility of our method, which allows us to extend this method to a larger patient cohort and adapt this automated technology to preoperative planning software.
肩盂组件松动是全肩关节置换术的主要并发症。更好地了解关节炎性盂肱关节腔解剖结构有助于开发新的植入物和技术。本研究的目的是描述和验证一种基于 CT 扫描的 3D 测量方法，用于描述各种特征关节炎性盂肱关节腔形态的参数，并验证其可重复性。
对 41 例接受解剖型肩假体的肩袖关节炎患者的 12 次 CT 扫描和 29 次 CT 关节造影进行了评估。根据 DICOM 文件对肩胛骨进行 3D 重建。在获得 3D 体积后，由 3 名观察者手动提取关节盂关节表面的点，每位观察者三次，每次间隔一周，以确定观察者内和观察者间的可重复性。计算了 5 个自动计算的 3D 参数的组内相关系数（ICC）：盂肱高度、盂肱宽度、最大宽度时的盂肱高度、盂肱关节面版本和关节面最佳拟合球体的半径。
观察者内和观察者间的 ICC 分别为 0.91 至 0.99 和 0.95 至 0.99。
本研究首次报道了一种基于 CT 扫描的关节炎性盂肱关节腔的可重复性 3D 测量方法，该方法推导了关节曲率半径等形态参数。与基于 2D CT 扫描的测量方法相比，这些 3D 测量方法具有优势，因为它们不受患者在 CT 扫描仪中的定位问题以及切片选择的影响，这限制了切片上测量的准确性。类似的 3D 方法已在健康的盂肱关节上得到验证。
本研究证实了我们的方法具有可靠性和良好的可重复性，使我们能够将该方法扩展到更大的患者队列，并将这种自动化技术应用于术前规划软件。
