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Current peri-operative imaging concepts surrounding shoulder arthroplasty

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Abstract

Glenohumeral osteoarthritis is a prevalent degenerative disease that can lead to excruciating pain and debility. End-stage osteoarthritis can be treated by both conservative and surgical interventions. Along with a comprehensive history and physical exam, pre-operative imaging with plain radiographs, computerized tomography, and magnetic resonance imaging plays an essential role in the decision-making process guiding whether the patient undergoes a shoulder hemiarthroplasty, anatomic total shoulder arthroplasty, or a reverse total shoulder arthroplasty. The most important pre-operative imaging factors are the integrity of the rotator cuff and presence of significant glenoid erosion. Imaging is also critical postoperatively, as signs of prosthetic loosening, rotator cuff failure (especially involving the subscapularis), periprosthetic fracture, and stress fractures are important entities to recognize. This article will review pertinent imaging findings related to the pre- and post-operative management of patients with glenohumeral osteoarthritis.

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References

  1. Wiater JM, Fabing MH. Shoulder arthroplasty: prosthetic options and indications. J Am Acad Orthop Surg. 2009;17(7):415–25.

    Article  PubMed  Google Scholar 

  2. R. Drake WV, A. Mitchell. Gray’s anatomy for students. 1st ed. Philadelphia: Elsevier/Churchill Livingstone; 2005.

  3. Moeckel BH, Dines DM, Warren RF, Altchek DW. Modular hemiarthroplasty for fractures of the proximal part of the humerus. J Bone Joint Surg Am. 1992;74(6):884–9.

    Article  CAS  PubMed  Google Scholar 

  4. Radnay CS, Setter KJ, Chambers L, Levine WN, Bigliani LU, Ahmad CS. Total shoulder replacement compared with humeral head replacement for the treatment of primary glenohumeral osteoarthritis: a systematic review. J Shoulder Elb Surg. 2007;16(4):396–402.

    Article  Google Scholar 

  5. Neer CS 2nd. Replacement arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am. 1974;56(1):1–13.

    Article  PubMed  Google Scholar 

  6. Bryant D, Litchfield R, Sandow M, Gartsman GM, Guyatt G, Kirkley A. A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis. J Bone Joint Surg Am. 2005;87(9):1947–56.

    Article  PubMed  Google Scholar 

  7. Edwards TB, Kadakia NR, Boulahia A, et al. A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study. J Shoulder Elbow Surg / Am Shoulder Elbow Surgeons [et al]. 2003;12(3):207–13.

    Article  Google Scholar 

  8. Lo IK, Litchfield RB, Griffin S, Faber K, Patterson SD, Kirkley A. Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial. J Bone Joint Surg Am. 2005;87(10):2178–85.

    PubMed  Google Scholar 

  9. Franklin JL, Barrett WP, Jackins SE, Matsen FA 3rd. Glenoid loosening in total shoulder arthroplasty. Association with rotator cuff deficiency. J Arthroplast. 1988;3(1):39–46.

    Article  CAS  Google Scholar 

  10. Fox TJ, Foruria AM, Klika BJ, Sperling JW, Schleck CD, Cofield RH. Radiographic survival in total shoulder arthroplasty. J Shoulder Elbow Surg / Am Shoulder Elbow Surgeons [et al]. 2013;22(9):1221–7.

    Article  Google Scholar 

  11. Deshmukh AV, Koris M, Zurakowski D, Thornhill TS. Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg / Am Shoulder Elbow Surgeons [et al]. 2005;14(5):471–9.

    Article  Google Scholar 

  12. Grammont P TP, Lafay JP, Deries X. Concept study and realization of a new total shoulder prosthesis. Rhumatologie. 1987;39.

  13. Gerber C, Pennington SD, Nyffeler RW. Reverse total shoulder arthroplasty. J Am Acad Orthopaed Surg. 2009;17(5):284–95.

    Article  Google Scholar 

  14. Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87(8):1697–705.

    PubMed  Google Scholar 

  15. Samilson RL, Prieto V. Dislocation arthropathy of the shoulder. J Bone Joint Surg Am. 1983;65(4):456–60.

    Article  CAS  PubMed  Google Scholar 

  16. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;254:92–6.

    Google Scholar 

  17. Stephens SP, Paisley KC, Jeng J, Dutta AK, Wirth MA. Shoulder arthroplasty in the presence of posterior glenoid bone loss. J Bone Joint Surg Am. 2015;97(3):251–9.

    Article  PubMed  Google Scholar 

  18. Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am. 1992;74(7):1032–7.

    Article  CAS  PubMed  Google Scholar 

  19. Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast. 1999;14(6):756–60.

    Article  CAS  Google Scholar 

  20. Budge MD, Lewis GS, Schaefer E, Coquia S, Flemming DJ, Armstrong AD. Comparison of standard two-dimensional and three-dimensional corrected glenoid version measurements. J Shoulder Elbow Surg / Am Shoulder Elbow Surg [et al]. 2011;20(4):577–83.

    Article  Google Scholar 

  21. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78–83.

    Google Scholar 

  22. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 1999;8(6):599–605.

    Article  CAS  Google Scholar 

  23. Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med. 2007;35(5):719–28.

    Article  PubMed  Google Scholar 

  24. Goutallier D, Postel JM, Gleyze P, Leguilloux P, Van Driessche S. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2003;12(6):550–4.

    Article  Google Scholar 

  25. Edwards TB, Boulahia A, Kempf JF, Boileau P, Nemoz C, Walch G. The influence of rotator cuff disease on the results of shoulder arthroplasty for primary osteoarthritis: results of a multicenter study. J Bone Joint Surg Am. 2002;84-a(12):2240–8.

    Article  Google Scholar 

  26. Gonzalez JF, Alami GB, Baque F, Walch G, Boileau P. Complications of unconstrained shoulder prostheses. J Shoulder Elb Surg. 2011;20(4):666–82.

    Article  Google Scholar 

  27. Deutsch A, Abboud JA, Kelly J, et al. Clinical results of revision shoulder arthroplasty for glenoid component loosening. J Shoulder Elb Surg. 2007;16(6):706–16.

    Article  Google Scholar 

  28. Cheung E, Willis M, Walker M, Clark R, Frankle MA. Complications in reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 2011;19(7):439–49.

    Article  PubMed  Google Scholar 

  29. Scalise JJ, Codsi MJ, Bryan J, Brems JJ, Iannotti JP. The influence of three-dimensional computed tomography images of the shoulder in preoperative planning for total shoulder arthroplasty. J Bone Joint Surg Am. 2008;90(11):2438–45.

    Article  PubMed  Google Scholar 

  30. Iannotti JP, Weiner S, Rodriguez E, et al. Three-dimensional imaging and templating improve glenoid implant positioning. J Bone Joint Surg Am. 2015;97(8):651–8.

    Article  PubMed  Google Scholar 

  31. Venne G, Rasquinha BJ, Pichora D, Ellis RE, Bicknell R. Comparing conventional and computer-assisted surgery baseplate and screw placement in reverse shoulder arthroplasty. J Shoulder Elb Surg. 2015;24(7):1112–9.

    Article  Google Scholar 

  32. Pearl ML. Proximal humeral anatomy in shoulder arthroplasty: Implications for prosthetic design and surgical technique. Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons [et al]. 2005;14(1 Suppl S):99s–104s.

    Article  Google Scholar 

  33. Pearl ML, Kurutz S, Postacchini R. Geometric variables in anatomic replacement of the proximal humerus: how much prosthetic geometry is necessary? J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2009;18(3):366–70.

    Article  Google Scholar 

  34. Sanchez-Sotelo J, Cofield RH, Rowland CM. Shoulder hemiarthroplasty for glenohumeral arthritis associated with severe rotator cuff deficiency. J Bone Joint Surg. 2001;83(12):1814–22.

    Article  CAS  PubMed  Google Scholar 

  35. Iannotti JP, Spencer EE Jr, Winter U, Deffenbaugh D, Williams G. Prosthetic positioning in total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery. 2005;14(1, Supplement):S111–21.

    Article  Google Scholar 

  36. Merolla G, Di Pietto F, Romano S, Paladini P, Campi F, Porcellini G. Radiographic analysis of shoulder anatomical arthroplasty. Eur J Radiol. 2008;68(1):159–69.

    Article  PubMed  Google Scholar 

  37. Sanchez-Sotelo J, Wright TW, O’Driscoll SW, Cofield RH, Rowland CM. Radiographic assessment of uncemented humeral components in total shoulder arthroplasty. J Arthroplast. 2001;16(2):180–7.

    Article  CAS  Google Scholar 

  38. Alolabi B, Youderian AR, Napolitano L, et al. Radiographic assessment of prosthetic humeral head size after anatomic shoulder arthroplasty. J Shoulder Elbow Surg / Am Shoulder Elbow Surg [et al]. 2014;23(11):1740–6.

    Article  Google Scholar 

  39. Ives EP, Nazarian LN, Parker L, Garrigues GE, Williams GR. Subscapularis tendon tears: a common sonographic finding in symptomatic postarthroplasty shoulders. J Clin Ultrasound : JCU. 2013;41(3):129–33.

    Article  PubMed  Google Scholar 

  40. Cofield RH, Edgerton BC. Total shoulder arthroplasty: complications and revision surgery. Instr Course Lect. 1990;39:449–62.

    CAS  PubMed  Google Scholar 

  41. Shi LL, Jiang JJ, Ek ET, Higgins LD. Failure of the lesser tuberosity osteotomy after total shoulder arthroplasty. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2015;24(2):203–9.

    Article  Google Scholar 

  42. Sofka CM, Adler RS. Original report. Sonographic evaluation of shoulder arthroplasty. AJR Am J Roentgenol. 2003;180(4):1117–20.

    Article  PubMed  Google Scholar 

  43. Walch G, Boileau, P. Shoulder Arthroplasty. 2 ed: Springer; 1999.

  44. Athwal GS, Sperling JW, Rispoli DM, Cofield RH. Periprosthetic humeral fractures during shoulder arthroplasty. J Bone Joint Surg Am. 2009;91(3):594–603.

    Article  PubMed  Google Scholar 

  45. Steinmann SP, Cheung EV. Treatment of periprosthetic humerus fractures associated with shoulder arthroplasty. J Am Acad Orthop Surg. 2008;16(4):199–207.

    Article  PubMed  Google Scholar 

  46. Bohsali KI, Wirth MA, Rockwood CA Jr. Complications of total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88(10):2279–92.

    PubMed  Google Scholar 

  47. Maynou C, Petroff E, Mestdagh H, Dubois HH, Lerue O. Clinical and radiologic outcome of humeral implants in shoulder arthroplasty. Acta Orthop Belg. 1999;65(1):57–64.

    CAS  PubMed  Google Scholar 

  48. Sanchez-Sotelo J, O’Driscoll SW, Torchia ME, Cofield RH, Rowland CM. Radiographic assessment of cemented humeral components in shoulder arthroplasty. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2001;10(6):526–31.

    Article  CAS  Google Scholar 

  49. Sperling JW, Cofield RH, O’Driscoll SW, Torchia ME, Rowland CM. Radiographic assessment of ingrowth total shoulder arthroplasty. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2000;9(6):507–13.

    Article  CAS  Google Scholar 

  50. Gartsman GM, Elkousy HA, Warnock KM, Edwards TB, O’Connor DP. Radiographic comparison of pegged and keeled glenoid components. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2005;14(3):252–7.

    Article  Google Scholar 

  51. Moeckel BH, Altchek DW, Warren RF, Wickiewicz TL, Dines DM. Instability of the shoulder after arthroplasty. J Bone Joint Surg Am. 1993;75(4):492–7.

    Article  CAS  PubMed  Google Scholar 

  52. Buck FM, Jost B, Hodler J. Shoulder arthroplasty. Eur Radiol. 2008;18(12):2937–48.

    Article  PubMed  Google Scholar 

  53. Chalmers PN, Rahman Z, Romeo AA, Nicholson GP. Early dislocation after reverse total shoulder arthroplasty. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2014;23(5):737–44.

    Article  Google Scholar 

  54. Edwards TB, Williams MD, Labriola JE, Elkousy HA, Gartsman GM, O’Connor DP. Subscapularis insufficiency and the risk of shoulder dislocation after reverse shoulder arthroplasty. J Shoulder Elb Surg. 2009;18(6):892–6.

    Article  Google Scholar 

  55. Gallo RA, Gamradt SC, Mattern CJ, et al. Instability after reverse total shoulder replacement. J Shoulder Elb Surg. 2011;20(4):584–90.

    Article  Google Scholar 

  56. Boileau P, Watkinson D, Hatzidakis AM, Hovorka I. Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg/ Am Shoulder Elbow Surg [et al]. 2006;15(5):527–40.

    Article  Google Scholar 

  57. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Brit Vol. 2004;86(3):388–95.

    Article  CAS  Google Scholar 

  58. Crosby LA, Hamilton A, Twiss T. Scapula fractures after reverse total shoulder arthroplasty: classification and treatment. Clin Orthop Relat Res. 2011;469(9):2544–9.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Levy JC, Anderson C, Samson A. Classification of postoperative acromial fractures following reverse shoulder arthroplasty. J Bone Joint Surg Am. 2013;95(15):e104.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA

    Travis J. Dekker, J. R. Steele & G. E. Garrigues

  2. Department of Radiology, Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA

    E. V. Vinson

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  1. Travis J. Dekker
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Dekker, T.J., Steele, J.R., Vinson, E.V. et al. Current peri-operative imaging concepts surrounding shoulder arthroplasty. Skeletal Radiol 48, 1485–1497 (2019). https://doi.org/10.1007/s00256-019-03183-3

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