Rainey Joshua, Hameed Daniel, Sodhi Nipun, Malkani Arthur L, Mont Michael A
Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Department of Orthopaedic Surgery, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.
J Orthop. 2024 May 13;59:30-35. doi: 10.1016/j.jor.2024.05.007. eCollection 2025 Jan.
The prevalence of total shoulder arthroplasties is on the rise annually. Improvements in implant quality, construct stability, and surgical techniques have notably enhanced post-operative results, prompting an expansion of indications for shoulder arthroplasty. Despite its high success rate, opportunities for enhancement remain, especially in preoperative planning and intraoperative execution. Advanced imaging technologies offer significant potential in optimizing implant placement, thus improving the longevity of the procedure. To our knowledge, a comprehensive review examining the impact of advanced imaging on shoulder arthroplasty has yet to be conducted. This systematic review aims to investigate the benefits of advanced imaging technologies in this context, focusing on their application in preoperative planning, osteoarthritis assessment, intraoperative adjustments, patient-specific instrumentation, and navigational aids.
This review utilized a comprehensive search of PubMed to identify relevant studies published from 2000 to 2024, focusing on the application of various imaging techniques in shoulder arthroplasty. The search was conducted by two authors and centered on plain radiography, CT scans, and MRI. The selection criteria included availability of full-text articles, English language, direct comparison of imaging techniques, and a focus on patient outcomes, including discussions on broader applications such as intraoperative navigation and patient-specific instrumentation development.
Enhanced imaging techniques, particularly CT scans and MRIs, have been shown to significantly improve outcomes in shoulder arthroplasty. While plain radiographs remain standard, CT scans provide superior bony detail, crucial for evaluating glenoid wear and determining augmentation needs. Preoperative CT imaging has been demonstrated to enhance implant placement accuracy. Moreover, intraoperative technologies based on CT imaging, such as patient-specific instrumentation and navigation systems, contribute to better surgical results.
The benefits of CT imaging in shoulder arthroplasty significantly outweigh the associated costs. Current literature strongly supports the adoption of CT imaging in these procedures, particularly when used alongside modern operative technologies.
全肩关节置换术的普及率逐年上升。植入物质量、结构稳定性和手术技术的改进显著提高了术后效果，促使肩关节置换术的适应症扩大。尽管成功率很高，但仍有改进的空间，特别是在术前规划和术中操作方面。先进的成像技术在优化植入物放置方面具有巨大潜力，从而提高手术的持久性。据我们所知，尚未对先进成像对肩关节置换术的影响进行全面综述。本系统综述旨在探讨先进成像技术在此背景下的益处，重点关注其在术前规划、骨关节炎评估、术中调整、定制器械和导航辅助方面的应用。
本综述通过全面检索PubMed来识别2000年至2024年发表的相关研究，重点关注各种成像技术在肩关节置换术中的应用。检索由两位作者进行，以X线平片、CT扫描和MRI为中心。选择标准包括全文文章的可用性、英语、成像技术的直接比较以及对患者结局的关注，包括对术中导航和定制器械开发等更广泛应用的讨论。
增强成像技术，特别是CT扫描和MRI，已被证明能显著改善肩关节置换术的效果。虽然X线平片仍是标准检查，但CT扫描提供了更优越的骨质细节，这对于评估肩胛盂磨损和确定增强需求至关重要。术前CT成像已被证明可提高植入物放置的准确性。此外，基于CT成像的术中技术，如定制器械和导航系统，有助于取得更好的手术效果。
CT成像在肩关节置换术中的益处明显超过相关成本。当前文献强烈支持在这些手术中采用CT成像，特别是与现代手术技术一起使用时。
