Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instability
Background: This study aims to determine the effect of time and imaging modality (three-dimensional (3D) CT vs. 3D magnetic resonance imaging (MRI)) on the surgical procedure indicated for shoulder instability. The hypothesis is there will be no clinical difference in procedure selection between tim...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323002190 |
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| author | Alexandra V. Paul, MD Imoh Udoh, BS Ananyaa Bharadwaj, BS Steven Bokshan, MD Brett D. Owens, MD William N. Levine, MD Grant E. Garrigues, MD Jeffrey S. Abrams, MD Patrick J. McMahon, MD Anthony Miniaci, MD Sameer Nagda, MD Jonathan P. Braman, MD Peter MacDonald, MD Jonathan C. Riboh, MD Scott Kaar, MD Brian Lau, MD |
| author_facet | Alexandra V. Paul, MD Imoh Udoh, BS Ananyaa Bharadwaj, BS Steven Bokshan, MD Brett D. Owens, MD William N. Levine, MD Grant E. Garrigues, MD Jeffrey S. Abrams, MD Patrick J. McMahon, MD Anthony Miniaci, MD Sameer Nagda, MD Jonathan P. Braman, MD Peter MacDonald, MD Jonathan C. Riboh, MD Scott Kaar, MD Brian Lau, MD |
| author_sort | Alexandra V. Paul, MD |
| collection | DOAJ |
| description | Background: This study aims to determine the effect of time and imaging modality (three-dimensional (3D) CT vs. 3D magnetic resonance imaging (MRI)) on the surgical procedure indicated for shoulder instability. The hypothesis is there will be no clinical difference in procedure selection between time and imaging modality. Methods: Eleven shoulder surgeons were surveyed with the same ten shoulder instability clinical scenarios at three time points. All time points included history of present illness, musculoskeletal exam, radiographs, and standard two-dimensional MRI. To assess the effect of imaging modality, survey 1 included 3D MRI while survey 2 included a two-dimensional and 3D CT scan. To assess the effect of time, a retest was performed with survey 3 which was identical to survey 2. The outcome measured was whether surgeons made a “major” or “minor” surgical change between surveys. Results: The average major change rate was 14.1% (standard deviation: 7.6%). The average minor change rate was 12.6% (standard deviation: 7.5%). Between survey 1 to the survey 2, the major change rate was 15.2%, compared to 13.1% when going from the second to the third survey (P = .68). The minior change rate between the first and second surveys was 12.1% and between the second to third interview was 13.1% (P = .8). Discussion: The findings suggest that the major factor related to procedural changes was time between reviewing patient information. Furthermore, this study demonstrates that there remains significant intrasurgeon variability in selecting surgical procedures for shoulder instability. Lastly, the findings in this study suggest that 3D MRI is clinically equivalent to 3D CT in guiding shoulder instability surgical management. Conclusion: This study demonstrates that there is significant variability in surgical procedure selection driven by time alone in shoulder instability. Surgical decision making with 3D MRI was similar to 3D CT scans and may be used by surgeons for preoperative planning. |
| first_indexed | 2024-03-07T22:00:00Z |
| format | Article |
| id | doaj.art-58f57d347bcb4c93a7cb9ba4f0c989c5 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-03-07T22:00:00Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-58f57d347bcb4c93a7cb9ba4f0c989c52024-02-24T04:55:35ZengElsevierJSES International2666-63832024-03-0182243249Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instabilityAlexandra V. Paul, MD0Imoh Udoh, BS1Ananyaa Bharadwaj, BS2Steven Bokshan, MD3Brett D. Owens, MD4William N. Levine, MD5Grant E. Garrigues, MD6Jeffrey S. Abrams, MD7Patrick J. McMahon, MD8Anthony Miniaci, MD9Sameer Nagda, MD10Jonathan P. Braman, MD11Peter MacDonald, MD12Jonathan C. Riboh, MD13Scott Kaar, MD14Brian Lau, MD15Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC, USA; Corresponding author: Alexandra V. Paul, MD, Duke University Medical Center, DUMC Box 3000, Durham, NC 27710, USA.Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC, USADepartment of Orthopedic Surgery, Duke University Medical Center, Durham, NC, USADepartment of Orthopedic Surgery, Duke University Medical Center, Durham, NC, USADepartment of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI, USADepartment of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USAMidwest Orthopaedics at RUSH, Rush University Medical Center, Chicago, IL, USAUniversity Medical Center at Princeton, Princeton, NJ, USAUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USADepartment of Orthopaedic Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USAAnderson Orthopaedic Clinic, Arlington, VA, USADepartment of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USAOrthopaedic Surgery, Pan Am Clinic, University of Manitoba, Winnipeg, MB, CanadaAtrium Health Musculoskeletal Institute, Charlotte, NC, USADepartment of Orthopaedic Surgery, Saint Louis University, St. Louis, MO, USADepartment of Orthopedic Surgery, Duke University Medical Center, Durham, NC, USABackground: This study aims to determine the effect of time and imaging modality (three-dimensional (3D) CT vs. 3D magnetic resonance imaging (MRI)) on the surgical procedure indicated for shoulder instability. The hypothesis is there will be no clinical difference in procedure selection between time and imaging modality. Methods: Eleven shoulder surgeons were surveyed with the same ten shoulder instability clinical scenarios at three time points. All time points included history of present illness, musculoskeletal exam, radiographs, and standard two-dimensional MRI. To assess the effect of imaging modality, survey 1 included 3D MRI while survey 2 included a two-dimensional and 3D CT scan. To assess the effect of time, a retest was performed with survey 3 which was identical to survey 2. The outcome measured was whether surgeons made a “major” or “minor” surgical change between surveys. Results: The average major change rate was 14.1% (standard deviation: 7.6%). The average minor change rate was 12.6% (standard deviation: 7.5%). Between survey 1 to the survey 2, the major change rate was 15.2%, compared to 13.1% when going from the second to the third survey (P = .68). The minior change rate between the first and second surveys was 12.1% and between the second to third interview was 13.1% (P = .8). Discussion: The findings suggest that the major factor related to procedural changes was time between reviewing patient information. Furthermore, this study demonstrates that there remains significant intrasurgeon variability in selecting surgical procedures for shoulder instability. Lastly, the findings in this study suggest that 3D MRI is clinically equivalent to 3D CT in guiding shoulder instability surgical management. Conclusion: This study demonstrates that there is significant variability in surgical procedure selection driven by time alone in shoulder instability. Surgical decision making with 3D MRI was similar to 3D CT scans and may be used by surgeons for preoperative planning.http://www.sciencedirect.com/science/article/pii/S2666638323002190Shoulder instabilitySports medicineOrthopedic surgeryShoulder surgeryShoulder dislocationArthroscopy |
| spellingShingle | Alexandra V. Paul, MD Imoh Udoh, BS Ananyaa Bharadwaj, BS Steven Bokshan, MD Brett D. Owens, MD William N. Levine, MD Grant E. Garrigues, MD Jeffrey S. Abrams, MD Patrick J. McMahon, MD Anthony Miniaci, MD Sameer Nagda, MD Jonathan P. Braman, MD Peter MacDonald, MD Jonathan C. Riboh, MD Scott Kaar, MD Brian Lau, MD Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instability JSES International Shoulder instability Sports medicine Orthopedic surgery Shoulder surgery Shoulder dislocation Arthroscopy |
| title | Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instability |
| title_full | Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instability |
| title_fullStr | Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instability |
| title_full_unstemmed | Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instability |
| title_short | Preoperative planning with three-dimensional CT vs. three-dimensional magnetic resonance imaging does not change surgical management for shoulder instability |
| title_sort | preoperative planning with three dimensional ct vs three dimensional magnetic resonance imaging does not change surgical management for shoulder instability |
| topic | Shoulder instability Sports medicine Orthopedic surgery Shoulder surgery Shoulder dislocation Arthroscopy |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323002190 |
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