Caecilia Charbonnier1, Sylvain Chagué2, Bart Kevelham2, Delphine Preissmann3, Frank C Kolo4, Olivier Rime5, Alexandre Lädermann6,7,8. 1. Medical Research Department, Artanim Foundation, 40 chemin du Grand-Puits, 1217, Meyrin, Switzerland. caecilia.charbonnier@artanim.ch. 2. Medical Research Department, Artanim Foundation, 40 chemin du Grand-Puits, 1217, Meyrin, Switzerland. 3. Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland. 4. Rive Droite Radiology Center, Geneva, Switzerland. 5. Division of Physiotherapy, La Tour Hospital, Meyrin, Switzerland. 6. Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland. 7. Faculty of Medicine, University of Geneva, Geneva, Switzerland. 8. Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
Abstract
PURPOSE: We present a computer-assisted planning solution "ArthroPlanner" for acromioplasty based on 3D anatomical models, computed tomography and joint kinematic simulations. METHODS: In addition to a standard static clinical evaluation (anamnesis, radiological examination), the software provides a dynamic assessment of the shoulder joint by computing in real time the joint kinematics from a database of activities of daily living. During motion, the precise bone resection (location and amount) is computed based on detected subacromial impingements, providing surgeons with precise information about the surgical procedure. Moreover, to improve the subjective reading of medical images, the software provides 3D measurement tools based on anatomical models assisting in the analysis of shoulder morphological features. RESULTS: We performed an in vivo assessment of the software in a prospective randomized clinical study conducted with 27 patients beneficiating from the planning solution and a control group of 31 patients without planning. Postoperatively, patient's pain decreased, and the shoulder range of motion and the functional outcomes improved significantly and the rotator cuff healing rate was good for both groups without intergroup differences. The amount of bone resected at surgery was comparable between the groups. The percentage of remaining impingement after surgery was in average reduced to 51% without groups difference. CONCLUSIONS:ArthroPlanner software includes all required materials (images data, 3D models, motion, morphological measurements, etc.) to improve orthopedists' performance in the surgical planning of acromioplasty. The solution offers a perfect analysis of the patient's anatomy and the ability to precisely analyze a dynamic mechanism to fully apprehend the patient's condition and to fulfill his/her expectations. The study however failed to detect any statistically significant difference in clinical outcomes and bone resection between the groups. Short-term clinical and radiological results were excellent in both groups.
RCT Entities:
PURPOSE: We present a computer-assisted planning solution "ArthroPlanner" for acromioplasty based on 3D anatomical models, computed tomography and joint kinematic simulations. METHODS: In addition to a standard static clinical evaluation (anamnesis, radiological examination), the software provides a dynamic assessment of the shoulder joint by computing in real time the joint kinematics from a database of activities of daily living. During motion, the precise bone resection (location and amount) is computed based on detected subacromial impingements, providing surgeons with precise information about the surgical procedure. Moreover, to improve the subjective reading of medical images, the software provides 3D measurement tools based on anatomical models assisting in the analysis of shoulder morphological features. RESULTS: We performed an in vivo assessment of the software in a prospective randomized clinical study conducted with 27 patients beneficiating from the planning solution and a control group of 31 patients without planning. Postoperatively, patient's pain decreased, and the shoulder range of motion and the functional outcomes improved significantly and the rotator cuff healing rate was good for both groups without intergroup differences. The amount of bone resected at surgery was comparable between the groups. The percentage of remaining impingement after surgery was in average reduced to 51% without groups difference. CONCLUSIONS: ArthroPlanner software includes all required materials (images data, 3D models, motion, morphological measurements, etc.) to improve orthopedists' performance in the surgical planning of acromioplasty. The solution offers a perfect analysis of the patient's anatomy and the ability to precisely analyze a dynamic mechanism to fully apprehend the patient's condition and to fulfill his/her expectations. The study however failed to detect any statistically significant difference in clinical outcomes and bone resection between the groups. Short-term clinical and radiological results were excellent in both groups.
Entities:
Keywords:
3D simulations; 3D surgical planning; Acromioplasty; Kinematics; Shoulder; Subacromial impingement
Authors: Alexander Maurer; Sandro F Fucentese; Christian W A Pfirrmann; Stephan H Wirth; Ali Djahangiri; Bernhard Jost; Christian Gerber Journal: J Shoulder Elbow Surg Date: 2011-10-29 Impact factor: 3.019
Authors: Mark K Timmons; Andrea Diniz Lopes-Albers; Lindsey Borgsmiller; Catherine Zirker; Jeff Ericksen; Lori A Michener Journal: Clin Biomech (Bristol, Avon) Date: 2013-03-06 Impact factor: 2.063