Computed tomography–based 3-dimensional preoperative planning for unlinked total elbow arthroplasty

Research output: Contribution to journalArticle

Abstract

Hypothesis: Three-dimensional (3D) surgical planning for unlinked total elbow arthroplasty (TEA) would be helpful for estimation of the implant size and accurate placement of implants. Methods: We included 28 patients who underwent TEA with an unlinked total elbow implant in this study. All patients underwent computed tomography scans of the elbow before surgery, and a 3D digital model of the elbow was reconstructed. After the appropriate size and position of the prosthesis were determined, 10 points around the bone tunnel (4 on the humerus and 6 on the ulna) were measured to plan the insertion of the humeral and ulnar stems. Two-dimensional planning was also performed using anteroposterior and lateral radiographs. Intraoperatively, the surgeon measured the planned parameters using a slide gauge to reproduce the 3D planned position of the stem insertion. Results: The stem sizes were accurately estimated in 57% of patients for the humerus and 68% for the ulna with 2-dimensional planning and in 86% for the humerus and 96% for the ulna with 3D planning. The mean differences between the positions of the prostheses after surgery with reference to the planned positions were 0.8° of varus and 1.5° of flexion for the humeral component and 0.7° of varus and 2.9° of flexion for the ulnar component. We did not evaluate rotational positioning in this study. Conclusions: The 3D surgical planning allowed accurate estimation of the implant size and appropriate placement of implants. This method may contribute to a reduced incidence of complications and improved long-term outcomes from TEA.

Original languageEnglish
JournalJournal of Shoulder and Elbow Surgery
DOIs
Publication statusAccepted/In press - 2018 Jan 1

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Elbow
Arthroplasty
Ulna
Humerus
Prostheses and Implants
Tomography
Bone and Bones
Incidence

Keywords

  • Computed tomography
  • K-NOW
  • surgical planning
  • three-dimensional planning
  • total elbow arthroplasty
  • unlinked type

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{d75f407c43a547518dcef55d61ab9be6,
title = "Computed tomography–based 3-dimensional preoperative planning for unlinked total elbow arthroplasty",
abstract = "Hypothesis: Three-dimensional (3D) surgical planning for unlinked total elbow arthroplasty (TEA) would be helpful for estimation of the implant size and accurate placement of implants. Methods: We included 28 patients who underwent TEA with an unlinked total elbow implant in this study. All patients underwent computed tomography scans of the elbow before surgery, and a 3D digital model of the elbow was reconstructed. After the appropriate size and position of the prosthesis were determined, 10 points around the bone tunnel (4 on the humerus and 6 on the ulna) were measured to plan the insertion of the humeral and ulnar stems. Two-dimensional planning was also performed using anteroposterior and lateral radiographs. Intraoperatively, the surgeon measured the planned parameters using a slide gauge to reproduce the 3D planned position of the stem insertion. Results: The stem sizes were accurately estimated in 57{\%} of patients for the humerus and 68{\%} for the ulna with 2-dimensional planning and in 86{\%} for the humerus and 96{\%} for the ulna with 3D planning. The mean differences between the positions of the prostheses after surgery with reference to the planned positions were 0.8° of varus and 1.5° of flexion for the humeral component and 0.7° of varus and 2.9° of flexion for the ulnar component. We did not evaluate rotational positioning in this study. Conclusions: The 3D surgical planning allowed accurate estimation of the implant size and appropriate placement of implants. This method may contribute to a reduced incidence of complications and improved long-term outcomes from TEA.",
keywords = "Computed tomography, K-NOW, surgical planning, three-dimensional planning, total elbow arthroplasty, unlinked type",
author = "Takuji Iwamoto and Taku Suzuki and Satoshi Oki and Noboru Matsumura and Masaya Nakamura and Morio Matsumoto and Kazuki Satou",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jse.2018.04.013",
language = "English",
journal = "Journal of Shoulder and Elbow Surgery",
issn = "1058-2746",
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TY - JOUR

T1 - Computed tomography–based 3-dimensional preoperative planning for unlinked total elbow arthroplasty

AU - Iwamoto, Takuji

AU - Suzuki, Taku

AU - Oki, Satoshi

AU - Matsumura, Noboru

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Satou, Kazuki

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Hypothesis: Three-dimensional (3D) surgical planning for unlinked total elbow arthroplasty (TEA) would be helpful for estimation of the implant size and accurate placement of implants. Methods: We included 28 patients who underwent TEA with an unlinked total elbow implant in this study. All patients underwent computed tomography scans of the elbow before surgery, and a 3D digital model of the elbow was reconstructed. After the appropriate size and position of the prosthesis were determined, 10 points around the bone tunnel (4 on the humerus and 6 on the ulna) were measured to plan the insertion of the humeral and ulnar stems. Two-dimensional planning was also performed using anteroposterior and lateral radiographs. Intraoperatively, the surgeon measured the planned parameters using a slide gauge to reproduce the 3D planned position of the stem insertion. Results: The stem sizes were accurately estimated in 57% of patients for the humerus and 68% for the ulna with 2-dimensional planning and in 86% for the humerus and 96% for the ulna with 3D planning. The mean differences between the positions of the prostheses after surgery with reference to the planned positions were 0.8° of varus and 1.5° of flexion for the humeral component and 0.7° of varus and 2.9° of flexion for the ulnar component. We did not evaluate rotational positioning in this study. Conclusions: The 3D surgical planning allowed accurate estimation of the implant size and appropriate placement of implants. This method may contribute to a reduced incidence of complications and improved long-term outcomes from TEA.

AB - Hypothesis: Three-dimensional (3D) surgical planning for unlinked total elbow arthroplasty (TEA) would be helpful for estimation of the implant size and accurate placement of implants. Methods: We included 28 patients who underwent TEA with an unlinked total elbow implant in this study. All patients underwent computed tomography scans of the elbow before surgery, and a 3D digital model of the elbow was reconstructed. After the appropriate size and position of the prosthesis were determined, 10 points around the bone tunnel (4 on the humerus and 6 on the ulna) were measured to plan the insertion of the humeral and ulnar stems. Two-dimensional planning was also performed using anteroposterior and lateral radiographs. Intraoperatively, the surgeon measured the planned parameters using a slide gauge to reproduce the 3D planned position of the stem insertion. Results: The stem sizes were accurately estimated in 57% of patients for the humerus and 68% for the ulna with 2-dimensional planning and in 86% for the humerus and 96% for the ulna with 3D planning. The mean differences between the positions of the prostheses after surgery with reference to the planned positions were 0.8° of varus and 1.5° of flexion for the humeral component and 0.7° of varus and 2.9° of flexion for the ulnar component. We did not evaluate rotational positioning in this study. Conclusions: The 3D surgical planning allowed accurate estimation of the implant size and appropriate placement of implants. This method may contribute to a reduced incidence of complications and improved long-term outcomes from TEA.

KW - Computed tomography

KW - K-NOW

KW - surgical planning

KW - three-dimensional planning

KW - total elbow arthroplasty

KW - unlinked type

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JF - Journal of Shoulder and Elbow Surgery

SN - 1058-2746

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