ArthroPlanner: a surgical planning solution for acromioplasty

• Published in: International journal for computer assisted radiology and surgery 2018-12, Vol.13 (12), p.2009-2019
• Main Authors: Charbonnier, Caecilia, Chagué, Sylvain, Kevelham, Bart, Preissmann, Delphine, Kolo, Frank C., Rime, Olivier, Lädermann, Alexandre
• Format: Article
• Language: English
• Subjects: Acromion - diagnostic imaging; Acromion - surgery; Adult; Arthroscopy - methods; Computed tomography; Computer Imaging; Computer Science; Computer simulation; Computing time; Decision Making, Computer-Assisted; Female; Health Informatics; Humans; Imaging; Imaging, Three-Dimensional - methods; Impingement; In vivo methods and tests; Kinematics; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Morphology; Original Article; Pain; Patients; Pattern Recognition and Graphics; Prospective Studies; Radiology; Range of Motion, Articular - physiology; Reconstructive Surgical Procedures - methods; Rotator Cuff Injuries - diagnosis; Rotator Cuff Injuries - surgery; Shoulder Joint - diagnostic imaging; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Software; Surgery; Surgical instruments; Three dimensional models; Three dimensional motion; Tomography, X-Ray Computed; Vision
• ISSN: 1861-6410; 1861-6429
• DOI: 10.1007/s11548-018-1707-9

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.