SciKit-SurgeryGlenoid, an Open Source Toolkit for Glenoid Version Measurement

Correct understanding of the geometry of the glenoid (the socket of the shoulder joint) is key to successful planning of shoulder replacement surgery. This surgery typically involves placing an implant in the shoulder joint to restore joint function. The most relevant geometry is the glenoid version, which is the angular orientation of the glenoid surface relative to the long axis of the scapula in the axial plane. However, measuring the glenoid version is not straightforward and there are multiple measurement methods in the literature and used in commercial planning software. In this paper we introduce SciKit-SurgeryGlenoid, an open source toolkit for the measurement of glenoid version. SciKit-SurgeryGlenoid contains implementations of the 4 most frequently used glenoid version measurement algorithms enabling easy and unbiased comparison of the different techniques. We present the results of using the software on 10 sets of pre-operative CT scans taken from patients who have subsequently undergone shoulder replacement surgery. We further compare these results with those obtained from a commercial implant planning software. SciKit-SurgeryGlenoid currently requires manual segmentation of the relevant anatomical features for each method. Future work will look at automating the segmentation process to build an automatic and repeatable pipeline from CT or radiograph to quantitative glenoid version measurement

Revision shoulder arthroplasty for failed humeral head resurfacing hemiarthroplasty

Background The purpose of the present study was to analyze and report the clinical outcomes following revision shoulder arthroplasty for failed humeral head resurfacing hemiarthroplasty (HHRH). Methods All patients who underwent revision shoulder arthroplasty for failed HHRH at our institution were retrospectively reviewed. Twenty-two shoulders in 20 patients were available for analysis. Mean age at the time of HHRH was 60 years (range 42 years to 75 years). The cohort consisted of 17 females and three males. Results The mean time from HHRH to revision was 5 years (range 1 year to 8 years). Mean age at the time of revision surgery was 62 years (range 44 years to 80 years). Patients were followed-up for a mean of 3.3 years (range 2 years to 4 years) after revision. Following revision surgery, there was an increase in forward elevation from 67° (range 0° to 130°) to 97° (range 40° to 160°) (p = 0.04). This was accompanied by an improvement in both the Oxford Shoulder Score and the subjective shoulder value, which increased from 13 (range 2 to 28) to 39 (range 24 to 48) (p = 0.000) and from 23 (range 0 to 65) to 79 (range 25 to 100) (p = 0.000) respectively. Conclusions Revision shoulder arthroplasty for failed HHRH improves functional outcome

A retrospective comparative study of bilateral total knee replacement staged at a one-week interval

The clinical results of bilateral total knee replacement staged at a one-week interval during a single hospital admission were compared with bilateral total knee replacements performed under the same anaesthetic and with bilateral total knee replacements performed during two separate admissions. The data were retrospectively reviewed. All operations had been performed by the same surgeon using the same design of prosthesis at a single institution. The operative time and length of stay for the one-week staged group were comparable with those of the separate admission group but longer than for the patients treated under one anaesthetic. There was a low rate of complications and good clinical outcome in all groups at a mean follow-up of four years (1 to 7.2). The group staged at a one-week interval had the least blood loss (p = 0.004). With appropriate patient selection, bilateral total knee replacement performed under a single anaesthetic, or staged at a one-week interval, is a safe and effective method to treat bilateral arthritis of the knee. M. C. Forster, A. J. Bauze, A. G. Bailie, M. S. Falworth, and R. D. Oakeshot

The provision of primary and revision elbow replacement surgery in the NHS

(Figure presented.) BESS Surgical Procedure Guidelines (SPGs). Optimising Surgical Outcomes for Shoulder and Elbow patients. The British Elbow and Shoulder Society (BESS) SPGs are a series of evidence and consensus Best Practice Recommendations developed by BESS surgeons and physiotherapists to help drive quality improvement and achieve the best possible surgical outcomes for UK patients. This SPG on primary and revision elbow replacement surgery is supported and endorsed by both the British Orthopaedic Association (BOA) and the Getting It Right First Time (GIRFT) Programme.</p