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ArthroPlanner: a surgical planning solution for acromioplasty

  • Original Article
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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

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.

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Notes

  1. The incidence of acromioplasty has increased dramatically in recent decades. According to the American Board of Orthopaedic Surgery database, the mean number of arthroscopic acromioplasties reported per candidate increased from 2.6 to 6.3 between 1999 and 2008, a 142.3% increase, compared to 13.0% increase in the mean number of all orthopedic procedures [38, 43].

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Acknowledgements

This study was funded by Fondation Hans Wilsdorf, a nonprofit foundation with no commercial interest in the present study. We would like to thank Camille Laroquais for her help with the 3D reconstruction and postoperative analysis.

Author information

Authors and Affiliations

  1. Medical Research Department, Artanim Foundation, 40 chemin du Grand-Puits, 1217, Meyrin, Switzerland

    Caecilia Charbonnier, Sylvain Chagué & Bart Kevelham

  2. Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland

    Delphine Preissmann

  3. Rive Droite Radiology Center, Geneva, Switzerland

    Frank C. Kolo

  4. Division of Physiotherapy, La Tour Hospital, Meyrin, Switzerland

    Olivier Rime

  5. Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland

    Alexandre Lädermann

  6. Faculty of Medicine, University of Geneva, Geneva, Switzerland

    Alexandre Lädermann

  7. Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

    Alexandre Lädermann

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  1. Caecilia Charbonnier
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  2. Sylvain Chagué
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Correspondence to Caecilia Charbonnier.

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The authors declare that they have no conflict of interest.

Research involving humans

Institutional ethical approval (CCER no. 15-151) was obtained prior to data collection, and the study was registered at ClinicalTrials.gov (NCT02725346). All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all participants included in the study.

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Charbonnier, C., Chagué, S., Kevelham, B. et al. ArthroPlanner: a surgical planning solution for acromioplasty. Int J CARS 13, 2009–2019 (2018). https://doi.org/10.1007/s11548-018-1707-9

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  • DOI: https://doi.org/10.1007/s11548-018-1707-9

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