OCM (Orthopädische Chirurgie München) Clinic, Steinerstrasse 6, 81369, Munich, Germany.
Arch Orthop Trauma Surg. 2023 Jul;143(7):3735-3741. doi: 10.1007/s00402-022-04571-6. Epub 2022 Aug 13.
Three-dimensional surgical planning software provides virtual reconstructions of the shoulder with automated joint indices for a preoperative case assessment. The aim of this single center study was to evaluate the concordance between the preoperatively selected humeral components and the final implants used in shoulder arthroplasty.
129 cases who had undergone anatomic (n = 16) or reverse shoulder arthroplasty (n = 117) using the same type of uncemented short stem implant and were included for review in this study. The type of arthroplasty, stem size, stem inclination, tray-offset and liner-thickness were noted preoperatively and compared to the final implant specifications used in surgery.
The type of arthroplasty matched the surgical plan in 99.2% of cases, as one case was converted from RSA to TSA. The concordance of planned to implanted stem size was 44.2% and the planned size was in range of one adjacent size in 87.6% of cases. Stem inclination in TSA matched the surgical plan in 50% of cases. Tray offset in RSA was predicted correctly in 65% and liner-thickness matched the surgical plan in 98.3% of cases.
Despite a low degree of concordance of planned to implanted stem sizes of 44.2%, the choice of stem size was found to be in range of one adjacent size in 87.6% of cases. Further investigations of other contributing factors are necessary to increase the accuracy of the preoperative selection of humeral implants.
level IV, retrospective case study.
三维手术规划软件可提供肩部的虚拟重建，并自动生成关节指数，用于术前病例评估。本单中心研究旨在评估术前选择的肱骨组件与肩关节置换术中最终使用的植入物之间的一致性。
回顾性分析了 129 例接受解剖型（n=16）或反肩关节置换术（n=117）的患者，所有患者均使用同种非骨水泥短柄植入物。记录术前的关节置换类型、柄尺寸、柄倾斜度、髋臼杯外展角和内衬厚度，并与术中最终使用的植入物规格进行比较。
99.2%的病例的关节置换类型与手术计划相匹配，1 例由 RSA 转为 TSA。计划与植入柄尺寸的一致性为 44.2%，87.6%的病例计划尺寸在相邻尺寸范围内。TSA 中柄倾斜度与手术计划一致的比例为 50%。RSA 中髋臼杯外展角预测准确的比例为 65%，内衬厚度与手术计划一致的比例为 98.3%。
尽管计划与植入柄尺寸的一致性仅为 44.2%，但在 87.6%的病例中，选择的柄尺寸在相邻尺寸范围内。需要进一步研究其他影响因素，以提高肱骨植入物术前选择的准确性。
IV 级，回顾性病例研究。
