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反肩关节置换术前规划中外科医生间及医生内差异的评估:一项多中心评估

Assessment of Inter- and Intrasurgeon Variability in Preoperative Planning of Reverse Shoulder Arthroplasty: A Multicenter Evaluation.

作者信息

Motta Filho Geraldo da Rocha, Amaral Marcus Vinicius Galvão, Nascimento Luis Gustavo Prata, Godinho André Couto, Checchia Caio Santos, Raffaelli Mauricio de Paiva, Pitta Rafael Peçanha, Leal Ana Carolina

机构信息

Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ, Brasil.

Divisão de Ensino e Pesquisa, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Aug 16;59(6):e950-e957. doi: 10.1055/s-0044-1788783. eCollection 2024 Dec.

Abstract

To evaluate the intra and intersurgeon variability regarding the positioning and selection of implants in reverse shoulder arthroplasty.  A cross-sectional study assessed computed tomography images of the shoulder joint of patients diagnosed with degenerative joint diseases. The study team included seven specialists in shoulder surgery, representing six different institutions. Surgeons were instructed to plan all cases twice, and then we evaluated inter- and intrasurgeon variability.  The interclass correlation for version and inclination showed low agreement concerning inclination (0.26), and moderate agreement for version (0.73) and graft selection (0.54). The intrasurgeon evaluation revealed a moderate correlation for version (0.55), inclination (0.58), and implant selection (0.46), while for lateralization the correlation was high (0.77).  This comparative study of preoperative planning by different surgeons showed the lack of consensus on implant positioning parameters during reverse shoulder arthroplasty planning. However, most surgeons tend to plan for zero degrees of version and inclination.

摘要

评估在反式肩关节置换术中植入物定位和选择方面外科医生之间及内部的变异性。 一项横断面研究评估了被诊断患有退行性关节疾病患者肩关节的计算机断层扫描图像。研究团队包括来自六个不同机构的七位肩部手术专家。指导外科医生对所有病例进行两次手术规划,然后我们评估外科医生之间及内部的变异性。 版本和倾斜度的组内相关显示倾斜度方面一致性较低(0.26),版本方面一致性中等(0.73),移植物选择方面一致性中等(0.54)。外科医生内部评估显示版本(0.55)、倾斜度(0.58)和植入物选择(0.46)之间相关性中等,而对于侧方化,相关性较高(0.77)。 这项不同外科医生术前规划的比较研究表明,在反式肩关节置换术规划期间,植入物定位参数缺乏共识。然而,大多数外科医生倾向于规划版本和倾斜度为零度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fd4/11663061/a53083b941cb/10-1055-s-0044-1788783-i2400010en-1.jpg

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