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Forschungsdatenbank PMU-SQQUID

The importance of CT for the pre-operative surgical planning in recurrent anterior shoulder instability.
Moroder, P; Resch, H; Schnaitmann, S; Hoffelner, T; Tauber, M;
Arch Orthop Trauma Surg. 2013; 133(2):219-226
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Hoffelner Thomas
Moroder Philipp
Resch Herbert
Tauber Mark

Abstract

BACKGROUND
MRI is the current pre-operative imaging standard in recurrent anterior shoulder instability; however, CT has increasingly gained interest due to its advantages in the detection of bony glenoid defects. This study compares the value of CT imaging and MRI for pre-operative surgical planning in recurrent anterior shoulder instability.
Between 2006 and 2009, 83 patients presented to the author"s department with recurrent anterior shoulder instability. For 48 patients, both, pre-operative MRI and CT images were available. The respective patho-morphological descriptions were retrospectively compared with the intra-operative findings. The effect of each imaging technique on the pre-operative surgical planning was analyzed and the accuracy in predicting the necessity of open versus arthroscopic surgery was compared.
In determining the necessity of open versus arthroscopic surgery CT imaging rendered an inaccurate prediction in 4.8 % of the cases which is less than the 25.0 % calculated for MRI. (p = 0.019). MRI showed a low sensitivity (35.3 %) in the detection of significant glenoid bone defects (≥20 % of the glenoid width measured on en-face views using a best-fit circle technique) while CT imaging provided an accurate prediction of the intra-operative finding in all cases.
Despite the advantages of MRI in the detection of soft tissue damages in recurrent anterior shoulder instability CT imaging proved to be more important for pre-operative planning by prevailing in the detection of glenoid defects. Therefore, the replacement of MRI as preoperative imaging standard with CT imaging is recommended.


Useful keywords (using NLM MeSH Indexing)

Adult

Aged

Female

Humans

Joint Instability/diagnosis*

Joint Instability/radiography

Joint Instability/surgery

Magnetic Resonance Imaging

Male

Middle Aged

Preoperative Period

Recurrence

Retrospective Studies

Shoulder Dislocation/diagnosis*

Shoulder Dislocation/radiography

Shoulder Dislocation/surgery

Shoulder Joint*

Tomography, X-Ray Computed*


Find related publications in this database (Keywords)

Recurrent anterior shoulder instability
Shoulder instability
CT imaging
MRI
Glenoid bone loss
Glenoid defect
Labral tear