Three-dimensional Volumetric Filling Ratio Predicts Stress Shielding in Short-stem Anatomic Total Shoulder Arthroplasty.
J Am Acad Orthop Surg
; 28(24): 1047-1054, 2020 Dec 15.
Article
em En
| MEDLINE
| ID: mdl-32301819
ABSTRACT
INTRODUCTION:
Three-dimensional (3-D) CT volumetric filling ratio (VFR) is a better predictor of proximal humerus stress shielding after short-stem anatomic total shoulder arthroplasty (aTSA) than using plain radiographs.METHODS:
Forty-four patients with short-stem aTSAs, preoperative CT scans, and a minimum 3-year radiographic follow-up were included. Patients were divided into group A (stress shielding) and group B (no stress shielding) based on the radiographic analysis. Standard implant filling ratios were measured on plain radiographs. The 3-D VFR of the metaphyseal and diaphyseal segments of the aTSA stem was measured using MIMICS (Materialise). The area under a receiver operator characteristic curve was used to determine the predictive strength of the 3-D VFR method.RESULTS:
The average age and radiographic follow-up was 69 years and 44 months. Group A had 19 patients and statistically higher filling ratios using 3-D VFR method than group B, whereas no notable differences were found between the groups using standard techniques. The 3-D VFR had an area under a receiver operator characteristic curve of 92%, which supports it as a good predictor of stress shielding.CONCLUSIONS:
These methods enable early identification of patients at risk for stress shielding and can also be valuable in improving humeral stem designs. LEVEL OF EVIDENCE Level III. Case-control study.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Articulação do Ombro
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Tomografia Computadorizada por Raios X
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Imageamento Tridimensional
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Artroplastia do Ombro
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Prótese de Ombro
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Úmero
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article