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Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening

BACKGROUND: It is believed that both patient and surgeon factors contribute to premature implant loosening. This video study was designed to answer the following questions: Can orthopedic surgeons reliably differentiate between procedures done well and those that will lead to early glenoid failure?...

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Autores principales: Simon, Peter, Streit, Jonathan J., Abboud, Joseph A., Mighell, Mark A., Williams, Gerald R., Frankle, Mark A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334877/
https://www.ncbi.nlm.nih.gov/pubmed/30675562
http://dx.doi.org/10.1016/j.jses.2017.11.001
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author Simon, Peter
Streit, Jonathan J.
Abboud, Joseph A.
Mighell, Mark A.
Williams, Gerald R.
Frankle, Mark A.
author_facet Simon, Peter
Streit, Jonathan J.
Abboud, Joseph A.
Mighell, Mark A.
Williams, Gerald R.
Frankle, Mark A.
author_sort Simon, Peter
collection PubMed
description BACKGROUND: It is believed that both patient and surgeon factors contribute to premature implant loosening. This video study was designed to answer the following questions: Can orthopedic surgeons reliably differentiate between procedures done well and those that will lead to early glenoid failure? Do the difficulty of the operation and the surgeon's performance predict a patient's outcome? Does the presence of a Walch B2 glenoid result in surgery that is evidently more difficult and performed in such a way to suggest early glenoid component failure? METHODS: Eleven upper extremity surgeons blindly graded a set of intraoperative videos of 15 total shoulder arthroplasty patients (grouped by outcome at 2 years). Evaluation questionnaires consisted of questions about the perceived difficulty and the surgeon's performance. Total and partial patient scores were calculated for each video. Higher calculated score would indicate worse postsurgical outcome. RESULTS: The loosening group had a significantly higher total score (P = .0057). Also, patients with B2 glenoids scored significantly higher than patients with other wear type. The analysis of overall procedure performance indicated difference between outcome groups (P = .0063). CONCLUSION: Our results indicate that surgeons could review surgical videos and differentiate the cases that were difficult or those that were more likely to lead to loosening of the glenoid component. The presence of a B2 glenoid was predictive of difficult surgery. The results of this study should serve as a starting point for surgeons interested in critically evaluating performance and also for those interested in finding ways to maximize patient outcomes after total shoulder arthroplasty.
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spelling pubmed-63348772019-01-23 Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening Simon, Peter Streit, Jonathan J. Abboud, Joseph A. Mighell, Mark A. Williams, Gerald R. Frankle, Mark A. JSES Open Access Article BACKGROUND: It is believed that both patient and surgeon factors contribute to premature implant loosening. This video study was designed to answer the following questions: Can orthopedic surgeons reliably differentiate between procedures done well and those that will lead to early glenoid failure? Do the difficulty of the operation and the surgeon's performance predict a patient's outcome? Does the presence of a Walch B2 glenoid result in surgery that is evidently more difficult and performed in such a way to suggest early glenoid component failure? METHODS: Eleven upper extremity surgeons blindly graded a set of intraoperative videos of 15 total shoulder arthroplasty patients (grouped by outcome at 2 years). Evaluation questionnaires consisted of questions about the perceived difficulty and the surgeon's performance. Total and partial patient scores were calculated for each video. Higher calculated score would indicate worse postsurgical outcome. RESULTS: The loosening group had a significantly higher total score (P = .0057). Also, patients with B2 glenoids scored significantly higher than patients with other wear type. The analysis of overall procedure performance indicated difference between outcome groups (P = .0063). CONCLUSION: Our results indicate that surgeons could review surgical videos and differentiate the cases that were difficult or those that were more likely to lead to loosening of the glenoid component. The presence of a B2 glenoid was predictive of difficult surgery. The results of this study should serve as a starting point for surgeons interested in critically evaluating performance and also for those interested in finding ways to maximize patient outcomes after total shoulder arthroplasty. Elsevier 2018-03-13 /pmc/articles/PMC6334877/ /pubmed/30675562 http://dx.doi.org/10.1016/j.jses.2017.11.001 Text en © 2017 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Simon, Peter
Streit, Jonathan J.
Abboud, Joseph A.
Mighell, Mark A.
Williams, Gerald R.
Frankle, Mark A.
Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening
title Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening
title_full Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening
title_fullStr Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening
title_full_unstemmed Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening
title_short Quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening
title_sort quantitative videographic analysis of intraoperative total shoulder arthroplasty is predictive of radiographic implant loosening
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334877/
https://www.ncbi.nlm.nih.gov/pubmed/30675562
http://dx.doi.org/10.1016/j.jses.2017.11.001
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