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Evaluation of lengthening in reverse shoulder arthroplasty comparing X-rays and computerised tomography

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Abstract

Purpose

The correct amount of arm lengthening in reverse shoulder arthroplasty is crucial to provide joint stability and good results. Determination has been proposed according to radiographs. However, radiographic measurements are error prone in regards to positioning of the arm with regard to the radiographic beam. The purpose of this study was to evaluate the precision of radiographic measurements compared to CT scans of the upper limb following reverse shoulder arthroplasty.

Methods

Thirty patients undergoing onlay reverse shoulder arthroplasty with comparative radiographs and CT scans of both humeri were included in this study. Arm length, humeral length as well as the arm and humeral lengthening were evaluated on pre- and postoperative radiographs compared to postoperative CT scans following a previously validated protocol.

Results

We found an excellent correlation for arm length and humeral length for radiographic and CT measurements (r > 0.90). The postoperative humeral and arm lengthening compared to the contralateral side was 0.1 (−1.2 to 1.2) cm and 2.8 (0.2 to 5.2) cm for the CT scans, and −0.6 (−4.1 to 2.0) cm and 1.9 (−2.3 to 5.0) cm for the radiographs. For arm lengthening, correlation coefficient was good (r = 0.7) even though radiographs indicated arm shortening in five cases whereas arm lengthening was observed on CT scans.

Conclusions

Measurements on radiographs and CT scans are comparable in most of the cases. However, we observed some important variations that question the reliability of radiographic measurements in up to 20 % of cases. Therefore, a CT scan appears to be necessary in the event of postoperative complications (e.g., instability, neurological problems).

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Conflict of interest

Dr. Gilles Walch receives royalties from Tornier Company.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Générale de Santé, Hôpital Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008, Lyon, France

    Birgit S. Werner, Yannick Carrillon & Gilles Walch

  2. Kansas City University of Medicine and Biosciences, Kansas City, MO, USA

    Matthew Daggett

Authors
  1. Birgit S. Werner
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  2. Matthew Daggett
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  3. Yannick Carrillon
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  4. Gilles Walch
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Correspondence to Birgit S. Werner.

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Werner, B.S., Daggett, M., Carrillon, Y. et al. Evaluation of lengthening in reverse shoulder arthroplasty comparing X-rays and computerised tomography. International Orthopaedics (SICOT) 39, 2389–2394 (2015). https://doi.org/10.1007/s00264-015-2780-0

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  • DOI: https://doi.org/10.1007/s00264-015-2780-0

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