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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 2/2013

01-02-2013 | Arthroscopy and Sports Medicine

The importance of CT for the pre-operative surgical planning in recurrent anterior shoulder instability

Authors: Philipp Moroder, Herbert Resch, Silke Schnaitmann, Thomas Hoffelner, Mark Tauber

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2013

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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.

Methods

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.

Results

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.

Conclusion

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.
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Metadata
Title
The importance of CT for the pre-operative surgical planning in recurrent anterior shoulder instability
Authors
Philipp Moroder
Herbert Resch
Silke Schnaitmann
Thomas Hoffelner
Mark Tauber
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 2/2013
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-012-1656-7

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