Al Najjar Majed, Mehta Saurabh Sagar, Monga Puneet
The Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, UK.
J Clin Orthop Trauma. 2018 Jul-Sep;9(3):230-235. doi: 10.1016/j.jcot.2018.06.001. Epub 2018 Jun 15.
Computerised Tomography (CT) scans are conventionally employed to assess the glenoid morphology prior to total shoulder arthroplasty (TSA). This study explores the role of three-dimensional (3D) models for assessing glenoid morphology.
CT scans of 32 patients scheduled for TSA were reconstructed to scapular models using customised software and a desktop 3D printer. The size and aspect ratios were maintained. Glenoid version, glenoid maximum height and width, and the maximum acromion antero-posterior (AP) length were compared between the models and CT scans.
The models were an accurate qualitative reflection of scapular anatomy. The average retroversion in 3D models was 8.19°±30.8° compared to 10.26°±42.5° in scan images. The mean difference was 2.07°±24.6° (p=0.408). However, the mean absolute error was 5.02°±12.3°. The mean difference of the glenoid maximum width and the acromion maximum AP length was 0.22±3.33mm (p=0.862) and 0.32±14.12mm (p=0.213) respectively. However, the mean difference was significant for the glenoid maximum height measuring 3.67±12.04mm with p=0.004. The correlation between the examiners was high for all parameters, with intraclass correlation ranging between 0.94 and 0.99.
3D printing technology promises to be a useful tool for preoperative planning with accurate reproduction of transverse plane anatomy. 3D prints represent superior definition of reconstructed anatomical measures such as glenoid height as compared to conventional CT Scans.
在全肩关节置换术(TSA)之前,传统上采用计算机断层扫描(CT)来评估肩胛盂形态。本研究探讨三维(3D)模型在评估肩胛盂形态中的作用。
使用定制软件和桌面3D打印机,将32例计划进行TSA的患者的CT扫描重建为肩胛骨模型。保持尺寸和长宽比。比较模型与CT扫描之间的肩胛盂版本、肩胛盂最大高度和宽度以及肩峰最大前后(AP)长度。
模型是肩胛骨解剖结构的准确定性反映。3D模型中的平均后倾角度为8.19°±30.8°,而扫描图像中的为10.26°±42.5°。平均差异为2.07°±24.6°(p = 0.408)。然而,平均绝对误差为5.02°±12.3°。肩胛盂最大宽度和肩峰最大AP长度的平均差异分别为0.22±3.33mm(p = 0.862)和0.32±14.12mm(p = 0.213)。然而,肩胛盂最大高度的平均差异显著,为3.67±12.04mm,p = 0.004。所有参数检查者之间的相关性都很高,组内相关性在0.94至0.99之间。
3D打印技术有望成为术前规划的有用工具,能够准确再现横断面解剖结构。与传统CT扫描相比,3D打印在重建解剖测量(如肩胛盂高度)方面具有更高的清晰度。