Dataset Information

Templating in shoulder arthroplasty - A comparison of 2D CT to 3D CT planning software: A systematic review.

ABSTRACT:

Background

Computed tomography (CT) utilizing computer software technology to generate three-dimensional (3D) rendering of the glenoid has become the preferred method for preoperative planning. It remains largely unknown what benefits this software may have to the intraoperative placement of the components and patient outcomes.

Purpose

The purpose of this systematic review is to compare 2D CT to 3D CT planning in total shoulder arthroplasty.

Study design

Systematic review.

Methods

A systematic database search was conducted for relevant studies evaluating the role of 3D CT planning in total shoulder arthroplasty. The primary outcome was component placement variability, and the secondary outcomes were intra- and inter-observer reliability in the context of preoperative planning.

Results

Following title-abstract and full-text screening, six eligible studies were included in the review (n = 237). The variability in glenoid measurements between 3D CT and 2D CT planning ranged from no significant difference to a 5° difference in version and 1.7° difference in inclination (p<0.05). Posterior bone loss was underestimated in 52% of the 2D measured patients relative to 3D CT groups. Irrespective of 2D and 3D planning (39% and 43% of cases respectively), surgeons elected to implant larger components than those templated. There was no literature identified comparing differences in time, cost, functional outcomes, complications, or patient satisfaction.

Conclusion

The paucity of evidence exploring clinical parameters makes it difficult to comment on clinical outcomes using different methods of templating. More studies are required to identify how improved radiographic outcomes translate into improvements that are clinically meaningful to patients.

SUBMITTER: Olaiya OR

PROVIDER: S-EPMC7545523 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundParkinson's disease (PD) is a neurodegenerative disorder associated with inferior clinical outcomes after surgical management of many orthopedic conditions. The purpose of this systematic review was to define the clinical, functional, and patient-reported outcomes of shoulder arthroplasty (SA) in patients with PD.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was completed using the Ovid platform for searches in MEDLINE, EMBASE, Cochrane Central, and Cochrane Systematic Reviews, with additional searches in Web of Science and Scopus. Included studies were full-length, English-language, clinical investigations reporting on SA in patients with PD with at least one clinical outcome.ResultsSeven studies including 7126 patients (7134 SA) met inclusion criteria with a mean age of 72.6 (range, 69.5-75.8 years), 58.9% female, and the average follow-up duration was 65 months (range, 17-119 months). Anatomic total shoulder arthroplasty (aTSA) was the most reported implant surgery (n = 3455, 48.4%) followed by hemiarthroplasty (HA) (n = 2840, 39.8%), and reverse shoulder arthroplasty (RSA) (n = 839,1.8%). SA consistently improved pain. Forward elevation, abduction, and external rotation had a pooled mean increase of 36°, 20°, and 6°, respectively. Complications occurred at a pooled rate of 22.5%, with stiffness (7.1%), need for revision (5.3%), and instability (4.7%) as the most common complications reported. Reoperations inclusive of revisions occurred at a lower pooled rate of 5.6%, with aTSA (n = 201; 9.0%) having the highest rate, followed by HA (n = 158; 7.1%), and then RSA (n = 42; 1.9%).ConclusionsThe results of the present systematic review demonstrate that SA in patients with PD results in consistent pain relief. However, inferior improvements in clinical outcomes may be expected when compared with patients without PD, likely due to the neurodegenerative manifestations of this disorder. In addition, RSA had a lower reoperation rate than HA and aTSA in patients with PD.