Preoperative planning in shoulder arthroplasty: what about the soft tissue?

4 pages•Published: December 13, 2022

Jean-David Werthel, François Boux de Casson, Cédric Manelli, Jean Chaoui, Gilles Walch and Valérie Burdin

Abstract

The primary objective of this study was to obtain a reliable method of automatic segmentation of shoulder muscles. The secondary objective of this study was to define a new computed tomography (CT)-based quantitative 3-dimensional (3D) measure of muscle loss (3DML) based on the rationale of the 2-dimensional (2D) qualitative Goutallier score. 102 CT scans were manually segmented and an algorithm of automated segmentation of the muscles was created. The volume of muscle fibers without intramuscular fat was then calculated for each rotator cuff muscle and normalized to the patient's scapular volume to account for the effect of body size (NVfibers). 3D muscle mass (3DMM) was calculated by dividing the NVfibers value of a given muscle by the mean expected volume in healthy shoulders. 3D muscle loss (3DML) was defined as 1 - (3DMM). Automated segmentation of the muscles was possible with a mean Dice of 0.904 ± 0.01 for the deltoid, 0.887 ± 0.014 for the infraspinatus (ISP), 0.892 ± 0.008 for the subscapularis (SSC), 0.885 for the supraspinatus (SSP) and 0.796 ± 0.006 for the teres minor (TM). The mean values of 3DFI and 3DML were 0.9% and 5.3% for Goutallier 0, 2.9% and 25.6% for Goutallier 1, 11.4% and 49.5% for Goutallier 2, 20.7% and 59.7% for Goutallier 3, and 29.3% and 70.2% for Goutallier 4, respectively. 3DML measurements obtained automatically incorporate both atrophy and fatty infiltration, thus they could become a very reliable index for assessing shoulder muscle function which could help in the decision process in shoulder surgery

Keyphrases: atrophy, automated segmentation, fatty infiltration, preoperative planning, rotator cuff, shoulder arthroplasty, shoulder muscles

In: Ferdinando Rodriguez Y Baena, Joshua W Giles and Eric Stindel (editors). Proceedings of The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 5, pages 195-198.

Links:	https://easychair.org/publications/paper/KMl4
	https://doi.org/10.29007/x1n7

BibTeX entry

@inproceedings{CAOS2022:Preoperative_planning_shoulder_arthroplasty,
  author    = {Jean-David Werthel and François Boux de Casson and Cédric Manelli and Jean Chaoui and Gilles Walch and Valérie Burdin},
  title     = {Preoperative planning in shoulder arthroplasty: what about the soft tissue?},
  booktitle = {Proceedings of The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Ferdinando Rodriguez Y Baena and Joshua W Giles and Eric Stindel},
  series    = {EPiC Series in Health Sciences},
  volume    = {5},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/KMl4},
  doi       = {10.29007/x1n7},
  pages     = {195-198},
  year      = {2022}}

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