Baumgarten Keith M
Orthopedic Institute, Sioux Falls, SD, USA; Department of Surgery, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.
J Shoulder Elbow Surg. 2023 May;32(5):1088-1094. doi: 10.1016/j.jse.2022.12.009. Epub 2023 Jan 20.
Blueprint 3-dimensional computed tomography software has a functionality that predicts impingement-free range of motion (ROM) with determination of the limits of ROM at which bone and/or prosthetic impingement occurs. To our knowledge, only 1 previously published study has assessed the ability of Blueprint software to predict actual postoperative ROM after reverse total shoulder arthroplasty (RTSA). The hypotheses of this study were that (1) mean Blueprint-predicted impingement-free ROM would be statistically similar to the mean actual ROM 1 year after RTSA and (2) there would be a correlation between Blueprint-predicted impingement-free ROM and the actual ROM 1 year after RTSA.
A retrospective review of patients who underwent Blueprint planning prior to undergoing RTSA from March 2017 through May 2021 was performed. At 1-year follow-up, flexion, external rotation at the side, abduction, external rotation in the abducted position, internal rotation in the abducted position, and internal rotation behind the back were measured. The preoperatively predicted flexion, extension, abduction, external rotation, and internal rotation were recorded using Blueprint software. The group 1 analysis examined the predicted vs. actual ROM of all 127 patients regardless of whether intraoperative component modifications were made. The group 2 analysis examined the predicted vs. actual ROM of only the patients who did not undergo intraoperative changes that would affect the preoperative ROM prediction (n = 97). The group 3 analysis examined the predicted vs. actual ROM of group 2 combined with the 30 patients who underwent post hoc Blueprint planning modifications to account for the changes made intraoperatively (combined sample size of 127).
Of the 141 patients, 127 (90%) were available for 1-year follow-up. When the mean values of all 3 groups were examined, the actual ROM and predicted ROM were statistically significantly different (P < .0001) for flexion, external rotation, abduction, abduction-external rotation, and abduction-internal rotation. In group 1, a very weak or poor correlation was found between predicted internal rotation and actual abducted internal rotation (r = 0.19, P = .04). For all other ROM metrics in groups 1, 2, and 3, there were no correlations between predicted and actual ROM (P ≥ .07).
In its current state, preoperative Blueprint 3-dimensional computed tomography planning software is unable to accurately predict ROM 1 year after RTSA.
Blueprint三维计算机断层扫描软件具有一项功能，可通过确定发生骨和/或假体撞击时的活动范围（ROM）极限来预测无撞击活动范围。据我们所知，此前仅有一项已发表的研究评估了Blueprint软件预测全肩关节置换术（RTSA）后实际术后活动范围的能力。本研究的假设为：（1）RTSA术后1年，Blueprint预测的平均无撞击活动范围在统计学上与平均实际活动范围相似；（2）RTSA术后1年，Blueprint预测的无撞击活动范围与实际活动范围之间存在相关性。
对2017年3月至2021年5月期间在接受RTSA之前进行Blueprint规划的患者进行回顾性研究。在1年随访时，测量了屈曲、体侧外旋、外展、外展位外旋、外展位内旋以及背后内旋情况。使用Blueprint软件记录术前预测的屈曲、伸展、外展、外旋和内旋情况。第1组分析检查了所有127例患者的预测活动范围与实际活动范围，无论术中是否对假体组件进行了修改。第2组分析仅检查了未进行会影响术前活动范围预测的术中改变的患者（n = 97）的预测活动范围与实际活动范围。第3组分析检查了第2组的预测活动范围与实际活动范围，并结合了30例接受事后Blueprint规划修改以考虑术中所做改变的患者（合并样本量为127）。
141例患者中，127例（90%）可进行1年随访。当检查所有3组的平均值时，屈曲、外旋、外展、外展 - 外旋和外展 - 内旋的实际活动范围和预测活动范围在统计学上有显著差异（P <.0001）。在第1组中，预测内旋与实际外展位内旋之间的相关性非常弱或较差（r = 0.19，P =.04）。对于第1、2和3组中的所有其他活动范围指标，预测活动范围与实际活动范围之间均无相关性（P≥.07）。
在当前状态下，术前Blueprint三维计算机断层扫描规划软件无法准确预测RTSA术后1年的活动范围。
