Moissenet, Florent, Bousigues, Sandrine, Boudabbous, Sana, Cabral, Davide, Gajny, Laurent, Hagemeister, Nicola et Holzer, Nicolas.
2025.
« Predicted impingement-free motion amplitudes in reverse total shoulder arthroplasty differs between supine computed tomography and standing biplanar x-ray imaging: a pilot study ».
JSES Reviews, Reports, and Techniques.
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Résumé
Preoperative planning software is widely used to assist surgeons in selecting and positioning implant components for reverse total shoulder arthroplasty (rTSA).14 These tools rely on patient-specific bone surface models derived from preoperative supine computed tomography (CT) scans and predict postoperative impingement-free motion amplitudes by simulating uniplanar humeral movements. However, a major limitation is that the CT scans are acquired in the supine position, which fails to account for the scapula posture in a standing position—a factor critical for clinical assessments.11 This discrepancy can significantly influence surgical planning.9,11 Studies by Moroder et al10 and Kriechling et al6 emphasize the importance of considering the scapula posture, as postoperative observations show its substantial impact on functional outcomes. Despite growing recognition of its importance, standardized and reliable methods for measuring scapula posture in the standing position are still lacking. Current studies, including those by Moroder et al10 and Kriechling et al,6 often rely on supine CT scans for adjusting the scapula posture. However, Matsumura et al8 demonstrated that the scapula posture significantly differs between supine and standing positions, raising concerns about the clinical relevance of supine imaging, which is influenced by the positioning of the shoulder and upper limb during recording. Moreover, defining the scapula posture in a thorax- or patient-referenced coordinate system (CS) typically requires whole thoraco-abdominal CT scans, which increases radiation exposure.9,11 To address these limitations, several alternative measurement methods are available. In particular, a novel solution by Bousigues et al2 involves low-dose biplanar radiography in a standing posture. When combined with conventional supine CT-based bone surface models, this approach could provide a clinically relevant tool for determining the scapula posture in the standing position prior to motion amplitude predictions. The aim of this pilot study was to evaluate the feasibility of this approach in determining impingement-free motion amplitudes. We hypothesized that adjusting the patient-specific scapula posture would significantly impact both the predicted impingement-free motion amplitudes (eg, flexion), range of motion (ROM, eg, flexion-extension), and the sites of impingement.
| Type de document: | Article publié dans une revue, révisé par les pairs |
|---|---|
| Professeur: | Professeur Hagemeister, Nicola |
| Affiliation: | Génie des systèmes |
| Date de dépôt: | 04 sept. 2025 13:00 |
| Dernière modification: | 24 sept. 2025 23:18 |
| URI: | https://espace2.etsmtl.ca/id/eprint/31631 |
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