Dataset Information

Three-Dimensional (3D) Animation and Calculation for the Assessment of Engaging Hill-Sachs Lesions With Computed Tomography 3D Reconstruction.

ABSTRACT:

Purpose

To dynamically assess for Hill-Sachs engagement with animated 3-dimensional (3D) shoulder models.

Methods

We created 3D shoulder models from reconstructed computed tomography (CT) images from a consecutive series of patients with recurrent anterior dislocation. They were divided into 2 groups based on the perceived Hill-Sachs severity. For our cohort of 14 patients with recurrent anterior dislocation, 4 patients had undergone osteoarticular allografting of Hill-Sachs lesions and 10 control patients had undergone CT scanning to quantify bone loss but no treatment for bony pathology. A biomechanical analysis was performed to rotate each 3D model using local coordinate systems to the classical vulnerable position of the shoulder (abduction = 90°, external rotation = 0-135°) and through a functional range. A Hill-Sachs lesion was considered "dynamically" engaging if the angle between the lesion's long axis and anterior glenoid was parallel. Results: In the vulnerable position of the shoulder, none of the Hill-Sachs lesions aligned with the anterior glenoid in any of our patients. However, in our simulated physiological shoulder range, all allograft patients and 70% of controls had positions producing alignment.

Conclusions

The technique offers a visual representation of an engaging Hill-Sachs using 3D-animated reconstructions with open-source software and CT images. In our series of patients, we found multiple shoulder positions that align the Hill-Sachs and glenoid axes that do not necessarily meet the traditional definition of engagement. Identifying all shoulder positions at risk of "engaging," in a broader physiological range, may have critical implications toward selecting the appropriate surgical management of bony defects.

Level of evidence

level III, case-control study.

SUBMITTER: Tat J

PROVIDER: S-EPMC7879177 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Three-Dimensional (3D) Animation and Calculation for the Assessment of Engaging Hill-Sachs Lesions With Computed Tomography 3D Reconstruction.

Tat Jimmy J Crawford Jordan J Chong Jaron J Powell Tom T Fevens Thomas G TG Popa Tiberiu T Martineau Paul A PA

Arthroscopy, sports medicine, and rehabilitation 20210130 1

<h4>Purpose</h4>To dynamically assess for Hill-Sachs engagement with animated 3-dimensional (3D) shoulder models.<h4>Methods</h4>We created 3D shoulder models from reconstructed computed tomography (CT) images from a consecutive series of patients with recurrent anterior dislocation. They were divided into 2 groups based on the perceived Hill-Sachs severity. For our cohort of 14 patients with recurrent anterior dislocation, 4 patients had undergone osteoarticular allografting of Hill-Sachs lesio ...[more]

PMID: 33615252

Similar Datasets

Project description:Glenohumeral instability causing bipolar bone loss is increasingly being recognized and treated to minimize recurrence. Large Hill–Sachs and reverse Hill–Sachs lesions of the humerus must be addressed at the time of surgery to prevent recurrent dislocations and restore the native anatomic track. For patients with epilepsy, locked dislocations may create defects that must be addressed with bony procedures, including osteochondral allograft reconstruction as soft-tissue remplissage may not adequately addresses the magnitude of the bone loss. Osteochondral allografts have been successfully used to address bony defects ranging from 20% to 30% of humeral bone loss whereas shoulder arthroplasty is indicated for larger defects where the native anatomy can no longer be restored. In this Technical Note, we present a technique to address concomitant large Hill–Sachs and reverse Hill–Sachs lesions. Technique Video Video 1 The patient in this case example has a large Hill–Sachs and reverse Hill–Sachs lesion of the left humeral head. A standard deltopectoral approach is performed. The subscapularis tendon is released via a subscapularis peel directly off of its insertion on the lesser tuberosity directly medial to the long head of the biceps tendon. Adequate release of the inferior capsule is performed to be able to access the humeral head lesions with extension and maximal external rotation. The lesions on the humeral head are prepared into flat surfaces with a sagittal saw. Bone wax is used to fill each defect to recreate native anatomy. The bone wax is used as a template to harvest the same size wedge from the proximal humeral osteochondral allograft on the back table. Two allograft wedges are harvested; one for the Hill–Sachs lesion and the other for the reverse Hill–Sachs lesion. The allograft wedges are fixed into each lesion with 3.5 mm cannulated headless compression screws (Acumed Acutrak headless compression screw system; Hillsboro, OR). The subscapularis is repaired via transosseous suture repair.

Dataset Information

Three-Dimensional (3D) Animation and Calculation for the Assessment of Engaging Hill-Sachs Lesions With Computed Tomography 3D Reconstruction.

Purpose

Methods

Conclusions

Level of evidence

Publications

Three-Dimensional (3D) Animation and Calculation for the Assessment of Engaging Hill-Sachs Lesions With Computed Tomography 3D Reconstruction.

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