Cargando…
The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty
Introduction: The purpose of this study was to analyze the real range of motion (RoM) measured in patients operated on for reverse shoulder arthroplasty (RSA) and compare it to the virtual RoM provided by the preoperative planning software. Hypothesis: There was a difference between virtual and real...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219507/ https://www.ncbi.nlm.nih.gov/pubmed/37240935 http://dx.doi.org/10.3390/jpm13050765 |
_version_ | 1785049026375188480 |
---|---|
author | Berhouet, Julien Samargandi, Ramy Favard, Luc Turbillon, Céline Jacquot, Adrien Gauci, Marc-Olivier |
author_facet | Berhouet, Julien Samargandi, Ramy Favard, Luc Turbillon, Céline Jacquot, Adrien Gauci, Marc-Olivier |
author_sort | Berhouet, Julien |
collection | PubMed |
description | Introduction: The purpose of this study was to analyze the real range of motion (RoM) measured in patients operated on for reverse shoulder arthroplasty (RSA) and compare it to the virtual RoM provided by the preoperative planning software. Hypothesis: There was a difference between virtual and real RoM, which can be explained by different factors, specifically the scapula-thoracic (ST) joint. Methods: Twenty patients with RSA were assessed at a minimum follow-up of 18 months. Passive RoM in forward elevation abduction, without and with manually locking the ST joint, and in external rotation with arm at side were recorded. The humerus, scapula, and implants were manually segmented on post-operative CTs. Post-operative bony structures were registered to preoperative bony elements. From this registration, a post-operative plan corresponding to the real post-operative implant positioning was generated and the corresponding virtual RoM analysis was recorded. On the post-operative anteroposterior X-rays and 2D-CT coronal planning view, the glenoid horizontal line angle (GH), the metaphyseal horizontal line angle (MH), and the gleno-metaphyseal angle (GMA) were measured to assess the extrinsic glenoid inclination, as well as the relative position of the humeral and glenoid components. Results: There were some significant differences between virtual and post-operative passive abduction and forward elevation, with (55° and 50°, p < 0.0001) or without ST joint participation (15° and 27°, p < 0.002). For external rotation with arm at side, there was no significant difference between planning (24° ± 26°) and post-operative clinical observation (19° ± 12°) (p = 0.38). For the angle measurements, the GMA was significantly higher (42.8° ± 15.2° vs. 29.1°± 18.2°, p < 0.0001), and the GH angle, significantly lower on the virtual planning (85.2° ± 8.8° vs. 99.5° ± 12.5°, p < 0.0001), while the MH was not different (p = 0.33). Conclusions: The virtual RoM given by the planning software used in this study differs from the real post-operative passive RoM, except for external rotation. This can be explained by the lack of ST joint and soft tissues simulation. However, in focusing on the virtual GH participation, the simulation looks informative. Some modifications between the glenoid and humerus starting positions before running the motion analysis could be provided for making it more realistic and predictive of the RSA functional results. Level of evidence: III. |
format | Online Article Text |
id | pubmed-10219507 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102195072023-05-27 The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty Berhouet, Julien Samargandi, Ramy Favard, Luc Turbillon, Céline Jacquot, Adrien Gauci, Marc-Olivier J Pers Med Communication Introduction: The purpose of this study was to analyze the real range of motion (RoM) measured in patients operated on for reverse shoulder arthroplasty (RSA) and compare it to the virtual RoM provided by the preoperative planning software. Hypothesis: There was a difference between virtual and real RoM, which can be explained by different factors, specifically the scapula-thoracic (ST) joint. Methods: Twenty patients with RSA were assessed at a minimum follow-up of 18 months. Passive RoM in forward elevation abduction, without and with manually locking the ST joint, and in external rotation with arm at side were recorded. The humerus, scapula, and implants were manually segmented on post-operative CTs. Post-operative bony structures were registered to preoperative bony elements. From this registration, a post-operative plan corresponding to the real post-operative implant positioning was generated and the corresponding virtual RoM analysis was recorded. On the post-operative anteroposterior X-rays and 2D-CT coronal planning view, the glenoid horizontal line angle (GH), the metaphyseal horizontal line angle (MH), and the gleno-metaphyseal angle (GMA) were measured to assess the extrinsic glenoid inclination, as well as the relative position of the humeral and glenoid components. Results: There were some significant differences between virtual and post-operative passive abduction and forward elevation, with (55° and 50°, p < 0.0001) or without ST joint participation (15° and 27°, p < 0.002). For external rotation with arm at side, there was no significant difference between planning (24° ± 26°) and post-operative clinical observation (19° ± 12°) (p = 0.38). For the angle measurements, the GMA was significantly higher (42.8° ± 15.2° vs. 29.1°± 18.2°, p < 0.0001), and the GH angle, significantly lower on the virtual planning (85.2° ± 8.8° vs. 99.5° ± 12.5°, p < 0.0001), while the MH was not different (p = 0.33). Conclusions: The virtual RoM given by the planning software used in this study differs from the real post-operative passive RoM, except for external rotation. This can be explained by the lack of ST joint and soft tissues simulation. However, in focusing on the virtual GH participation, the simulation looks informative. Some modifications between the glenoid and humerus starting positions before running the motion analysis could be provided for making it more realistic and predictive of the RSA functional results. Level of evidence: III. MDPI 2023-04-29 /pmc/articles/PMC10219507/ /pubmed/37240935 http://dx.doi.org/10.3390/jpm13050765 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Communication Berhouet, Julien Samargandi, Ramy Favard, Luc Turbillon, Céline Jacquot, Adrien Gauci, Marc-Olivier The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty |
title | The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty |
title_full | The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty |
title_fullStr | The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty |
title_full_unstemmed | The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty |
title_short | The Real Post-Operative Range of Motion Differs from the Virtual Pre-Operative Planned Range of Motion in Reverse Shoulder Arthroplasty |
title_sort | real post-operative range of motion differs from the virtual pre-operative planned range of motion in reverse shoulder arthroplasty |
topic | Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219507/ https://www.ncbi.nlm.nih.gov/pubmed/37240935 http://dx.doi.org/10.3390/jpm13050765 |
work_keys_str_mv | AT berhouetjulien therealpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT samargandiramy therealpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT favardluc therealpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT turbillonceline therealpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT jacquotadrien therealpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT gaucimarcolivier therealpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT berhouetjulien realpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT samargandiramy realpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT favardluc realpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT turbillonceline realpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT jacquotadrien realpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty AT gaucimarcolivier realpostoperativerangeofmotiondiffersfromthevirtualpreoperativeplannedrangeofmotioninreverseshoulderarthroplasty |