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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.

DOI:10.1055/s-0044-1788783
PMID:39711637
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11663061/
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。

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本文引用的文献

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Lateralization in Reverse Shoulder Arthroplasty.反向肩关节置换术中的侧别定位
J Clin Med. 2021 Nov 18;10(22):5380. doi: 10.3390/jcm10225380.
2
Preoperative planning of baseplate position in reverse shoulder arthroplasty: Still no consensus on lateralization, version and inclination.反式肩关节置换术中外侧板位置的术前规划：关于侧方移位、倾斜角和倾斜位仍无共识。
Orthop Traumatol Surg Res. 2022 May;108(3):103115. doi: 10.1016/j.otsr.2021.103115. Epub 2021 Oct 12.
3
Assessment of surgeon variability in preoperative planning of reverse total shoulder arthroplasty: a quantitative comparison of 49 cases planned by 9 surgeons.
评估在反向全肩关节置换术术前规划中外科医生的变异性：9 位外科医生规划的 49 例病例的定量比较。
J Shoulder Elbow Surg. 2020 Oct;29(10):2080-2088. doi: 10.1016/j.jse.2020.02.023. Epub 2020 May 26.
4
Is preoperative planning effective for intraoperative glenoid implant size and type selection during anatomic and reverse shoulder arthroplasty?术前规划在解剖型和反式肩关节置换术中对术中肩胛盂假体大小和类型的选择是否有效？
J Shoulder Elbow Surg. 2020 Oct;29(10):2123-2127. doi: 10.1016/j.jse.2020.01.098. Epub 2020 Apr 25.
5
Aseptic Glenoid Baseplate Loosening After Reverse Total Shoulder Arthroplasty: A Systematic Review and Meta-Analysis.反式全肩关节置换术后无菌性肩胛盂基板松动：一项系统评价与Meta分析
JBJS Rev. 2019 May;7(5):e7. doi: 10.2106/JBJS.RVW.18.00132.
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Version and inclination obtained with 3-dimensional planning in total shoulder arthroplasty: do different programs produce the same results?全肩关节置换术中三维规划获得的版本和倾斜度：不同程序会产生相同的结果吗？
JSES Open Access. 2018 Sep 21;2(4):200-204. doi: 10.1016/j.jses.2018.06.003. eCollection 2018 Dec.
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Optimizing reverse shoulder arthroplasty component position in the setting of advanced arthritis with posterior glenoid erosion: a computer-enhanced range of motion analysis.在伴有后肩胛盂骨侵蚀的晚期关节炎情况下优化反式肩关节置换术组件位置：计算机增强的活动范围分析。
J Shoulder Elbow Surg. 2018 Feb;27(2):339-349. doi: 10.1016/j.jse.2017.09.011.
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Automated Three-Dimensional Measurement of Glenoid Version and Inclination in Arthritic Shoulders.关节镜下评估骨关节炎患者肩盂倾斜角和前下倾斜角的新方法
J Bone Joint Surg Am. 2018 Jan 3;100(1):57-65. doi: 10.2106/JBJS.16.01122.
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