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全肩关节置换术中三维规划获得的版本和倾斜度:不同程序会产生相同的结果吗?

Version and inclination obtained with 3-dimensional planning in total shoulder arthroplasty: do different programs produce the same results?

作者信息

Denard Patrick J, Provencher Matthew T, Lädermann Alexandre, Romeo Anthony A, Parsons Bradford O, Dines Joshua S

机构信息

Southern Oregon Orthopedics, Medford, OR, USA.

Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.

出版信息

JSES Open Access. 2018 Sep 21;2(4):200-204. doi: 10.1016/j.jses.2018.06.003. eCollection 2018 Dec.

Abstract

BACKGROUND

Our purpose was to compare the output of glenoid measurements with 2 commercially available preoperative 3-dimensional (3D) total shoulder arthroplasty planning systems. The hypothesis was that there would be no difference in product-derived measurements between the systems.

METHODS

Preoperative 3D computed tomography scans of 63 consecutive patients undergoing primary arthroplasty were analyzed using 2 product-derived techniques: Blueprint and VIP. Glenoid version and inclination measurements with each system were blinded and statistically compared, and the amount of variance was recorded.

RESULTS

Glenoid version based on Blueprint was -10.9° ± 9.0° (range, -41° to 14°) compared with -9.3° ± 8.2° (range, -36° to 8°) for VIP ( = .04). Inclination was 9.0° ± 8.8° (range, -12° to 29°) with Blueprint compared with 9.7° ± 6.1° (range, -6° to 22°) for VIP ( = .463). For version, the difference between the 2 systems was less than 5° in 44 cases (69.8%), 5°-10° in 12 cases (19.0%), and greater than 10° in 7 cases (11.1%). For inclination, the difference was less than 5° in 34 cases (54.0%), 5°-10° in 17 cases (27.0%), and greater than 10° in 12 cases (19.0%). We found no differences in glenoid version or inclination based on glenoid morphology between the 2 systems ( = .908) and no differences between patients with the most severe arthritis and posterior wear ( = .202).

CONCLUSIONS

There is considerable variability between preoperative measurements obtained for 3D planning of shoulder arthroplasty with the use of Blueprint and VIP. Given that implant choice and desired component positioning are based on preoperative measurements, further study is needed to evaluate the differences between the measurements obtained with different techniques.

摘要

背景

我们的目的是比较使用两种商用术前三维(3D)全肩关节置换术规划系统得出的肩胛盂测量结果。假设是这两种系统在产品衍生测量结果上不会存在差异。

方法

对63例连续接受初次置换术患者的术前3D计算机断层扫描进行分析,采用两种产品衍生技术:Blueprint和VIP。对每个系统的肩胛盂版本和倾斜度测量结果进行盲法处理并进行统计学比较,记录差异量。

结果

基于Blueprint的肩胛盂版本为-10.9°±9.0°(范围为-41°至14°),而VIP为-9.3°±8.2°(范围为-36°至8°)(P = 0.04)。Blueprint测量的倾斜度为9.0°±8.8°(范围为-12°至29°),VIP为9.7°±6.1°(范围为-6°至22°)(P = 0.463)。对于版本,两种系统之间的差异在44例(69.8%)中小于5°,12例(19.0%)中为5°至10°,7例(11.1%)中大于10°。对于倾斜度,差异在34例(54.0%)中小于5°,17例(27.0%)中为5°至10°,12例(19.%)中大于10°。我们发现,基于肩胛盂形态,两种系统在肩胛盂版本或倾斜度上无差异(P = 0.908),在关节炎最严重和后方磨损的患者之间也无差异(P = 0.202)。

结论

使用Blueprint和VIP进行肩关节置换术3D规划的术前测量结果存在相当大的变异性。鉴于植入物的选择和所需部件的定位基于术前测量结果,需要进一步研究以评估不同技术获得的测量结果之间的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4df5/6334884/0d8f25667bf8/gr1.jpg

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