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Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty

BACKGROUND: Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement les...

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Autores principales: Yamamoto, Michiro, Murakami, Yukimi, Iwatsuki, Katsuyuki, Kurimoto, Shigeru, Hirata, Hitoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818897/
https://www.ncbi.nlm.nih.gov/pubmed/27039373
http://dx.doi.org/10.1186/s12891-016-0996-9
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author Yamamoto, Michiro
Murakami, Yukimi
Iwatsuki, Katsuyuki
Kurimoto, Shigeru
Hirata, Hitoshi
author_facet Yamamoto, Michiro
Murakami, Yukimi
Iwatsuki, Katsuyuki
Kurimoto, Shigeru
Hirata, Hitoshi
author_sort Yamamoto, Michiro
collection PubMed
description BACKGROUND: Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement lesions. METHODS: We developed a four-dimensional simulation system by adding the anatomical axis to the three-dimensional computed tomography scan data of the affected arm in one position. Eleven patients with primary degenerative elbow osteoarthritis were included. A “two rings” method was used to calculate the flexion-extension axis of the elbow by converting the surface of the trochlea and capitellum into two rings. A four-dimensional simulation movie was created and showed the optimal range of motion and the impingement area requiring excision. To evaluate the reliability of the flexion-extension axis, interobserver and intraobserver reliabilities regarding the assessment of bony overlap volumes were calculated twice for each patient by two authors. Patients were treated by open or arthroscopic debridement arthroplasties. Pre- and postoperative examinations included elbow range of motion measurement, and completion of the patient-rated questionnaire Hand20, Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score, and the Mayo Elbow Performance Score. RESULTS: Measurement of the bony overlap volume showed an intraobserver intraclass correlation coefficient of 0.93 and 0.90, and an interobserver intraclass correlation coefficient of 0.94. The mean elbow flexion-extension arc significantly improved from 101° to 125°. The mean Hand20 score significantly improved from 52 to 22. The mean Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score significantly improved from 67 to 88. The mean Mayo Elbow Performance Score significantly improved from 71 to 91 at the final follow-up evaluation. CONCLUSION: We showed that four-dimensional, preoperative simulation can be generated by adding the rotation axis to the one-position, three-dimensional computed tomography image of the affected arm. This method is feasible for elbow debridement arthroplasty. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-016-0996-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-48188972016-04-04 Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty Yamamoto, Michiro Murakami, Yukimi Iwatsuki, Katsuyuki Kurimoto, Shigeru Hirata, Hitoshi BMC Musculoskelet Disord Research Article BACKGROUND: Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement lesions. METHODS: We developed a four-dimensional simulation system by adding the anatomical axis to the three-dimensional computed tomography scan data of the affected arm in one position. Eleven patients with primary degenerative elbow osteoarthritis were included. A “two rings” method was used to calculate the flexion-extension axis of the elbow by converting the surface of the trochlea and capitellum into two rings. A four-dimensional simulation movie was created and showed the optimal range of motion and the impingement area requiring excision. To evaluate the reliability of the flexion-extension axis, interobserver and intraobserver reliabilities regarding the assessment of bony overlap volumes were calculated twice for each patient by two authors. Patients were treated by open or arthroscopic debridement arthroplasties. Pre- and postoperative examinations included elbow range of motion measurement, and completion of the patient-rated questionnaire Hand20, Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score, and the Mayo Elbow Performance Score. RESULTS: Measurement of the bony overlap volume showed an intraobserver intraclass correlation coefficient of 0.93 and 0.90, and an interobserver intraclass correlation coefficient of 0.94. The mean elbow flexion-extension arc significantly improved from 101° to 125°. The mean Hand20 score significantly improved from 52 to 22. The mean Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score significantly improved from 67 to 88. The mean Mayo Elbow Performance Score significantly improved from 71 to 91 at the final follow-up evaluation. CONCLUSION: We showed that four-dimensional, preoperative simulation can be generated by adding the rotation axis to the one-position, three-dimensional computed tomography image of the affected arm. This method is feasible for elbow debridement arthroplasty. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-016-0996-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-04-02 /pmc/articles/PMC4818897/ /pubmed/27039373 http://dx.doi.org/10.1186/s12891-016-0996-9 Text en © Yamamoto et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Yamamoto, Michiro
Murakami, Yukimi
Iwatsuki, Katsuyuki
Kurimoto, Shigeru
Hirata, Hitoshi
Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty
title Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty
title_full Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty
title_fullStr Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty
title_full_unstemmed Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty
title_short Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty
title_sort feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818897/
https://www.ncbi.nlm.nih.gov/pubmed/27039373
http://dx.doi.org/10.1186/s12891-016-0996-9
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