Mettu Sindhura, Shirodkar Kapil, Hussein Mohsin, Iyengar Karthikeyan P, Chapala Shashank, Botchu Rajesh
Department of Radiology, Himagiri Hospital, Hyderabad, India.
Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK.
J Clin Orthop Trauma. 2024 Jun 26;53:102472. doi: 10.1016/j.jcot.2024.102472. eCollection 2024 Jun.
Shoulder arthroplasty has become a standard surgical procedure for treating a variety of complex shoulder disorders, including those with degenerative and traumatic aetiologies. The ever-improving success rates of shoulder arthroplasty could be attributed to advancements in endoprosthesis design, improvements in the biomechanics of endoprosthetic components, and improvements in surgical techniques. It improves patient outcomes and helps restore shoulder joint function and mobility. Imaging plays a vital role by enabling surgeons to plan arthroplasty procedures, help guide endoprosthesis placement, and monitor postoperative outcomes. In addition, imaging plays a role in assessing the residual bone stock and status of rotator cuff integrity and in correcting the placement of prosthetic components to restore shoulder mobility. CT-guided navigation aids surgeons by helping them choose appropriate components for implants and ensuring that implants are placed optimally during surgery. It can lead to better surgical results with reduced patient morbidity and a longer duration of prosthetic stability. After surgery, it is crucial to use imaging techniques to detect issues such as periprosthetic loosening, infections, or fractures to start effective management strategies to enhance patient recovery. This article aims to provide orthopaedic surgeons and radiologists with knowledge on the imaging methods used in shoulder arthroplasty and their role in presurgical planning, intraoperative guidance and postoperative assessment. In this study, we aimed to investigate the rationale behind utilising various types of shoulder replacements: total shoulder replacement (TSA), reverse total shoulder arthroplasty (RTSA), and hemiarthroplasty; methods, their respective advantages and limitations; and outcomes. Our objective is to comprehensively analyse the procedures mentioned above and highlight their unique features and benefits to facilitate a better understanding of these approaches. Additionally, we will discuss how these imaging techniques help identify issues such as loose components, fractures around the implant site, joint instability and infections.
肩关节置换术已成为治疗各种复杂肩部疾病的标准外科手术，包括那些由退行性和创伤性病因引起的疾病。肩关节置换术成功率的不断提高可归因于人工关节假体设计的进步、人工关节假体部件生物力学的改善以及手术技术的改进。它改善了患者的治疗效果，有助于恢复肩关节功能和活动度。影像学在使外科医生能够规划关节置换手术、帮助引导人工关节假体的放置以及监测术后结果方面发挥着至关重要的作用。此外，影像学在评估残余骨量、肩袖完整性状态以及纠正假体部件的位置以恢复肩关节活动度方面也发挥着作用。CT引导导航通过帮助外科医生选择合适的植入部件并确保手术期间植入物的最佳放置来辅助外科医生。它可以带来更好的手术效果，降低患者发病率，并延长假体稳定性的持续时间。手术后，使用影像学技术检测假体周围松动、感染或骨折等问题，以启动有效的管理策略来促进患者康复至关重要。本文旨在为骨科医生和放射科医生提供有关肩关节置换术中使用的影像学方法及其在术前规划、术中引导和术后评估中的作用的知识。在本研究中，我们旨在研究使用各种类型肩关节置换术的基本原理：全肩关节置换术（TSA）、反式全肩关节置换术（RTSA）和半肩关节置换术；方法、它们各自的优点和局限性；以及结果。我们的目标是全面分析上述手术，并突出它们的独特特征和益处，以便更好地理解这些方法。此外，我们将讨论这些影像学技术如何帮助识别诸如部件松动、植入部位周围骨折、关节不稳定和感染等问题。
