Ausberto Velasquez Garcia

To present a novel evaluation technique for assessing three-dimensional (3D) prosthesis alignment after radial head arthroplasty (RHA) and to identify potential measurement errors associated with this method. Virtual surgical planning of a simulated irreparable fracture of the radial head was performed to select and place optimal implants. Of the six 3D-printed bone models, three were fitted with 3D-printed implants and three with metallic implants. After the procedure, 3D models were derived from 3D scans and dual-energy computed tomography with and without metal artifact reduction. Deviations in rotation and translation from the pre-procedure plan as well as measurement errors were assessed. The technique demonstrated the ability to accurately identify minor deviations in prosthesis alignment post-RHA. Deviations ranged from 0 to 14° in rotation and 0 to 1.3 mm in translation. The method also showed high measurement accuracy against 3D reference models, with mean rotational errors of 0.3-0.5° and translation errors of 0.1-0.3 mm. This technique provides an accurate and precise method for assessing prosthesis alignment in RHA, with minimal measurement errors. Its potential as a valuable clinical tool has substantial implications in improving preoperative planning and postoperative evaluation. Further validation and advancements in reducing operator dependency are necessary for clinical adoption.

The success of radial head arthroplasty (RHA) relies on the design of the implant and precision of the surgical technique, with preoperative planning potentially playing a crucial role. The accurate establishment of a patient‐specific anatomical coordinate system (ACS) is essential for this planning process. This study tested the hypothesis that an innovative automated method would be an accurate, reliable, and efficient framework to determine the ACS of the proximal radius, which would be a step toward improving the precision of RHA planning. We used advanced computational techniques to analyze 50 forearm CT scans, comparing the accuracy, reproducibility, reliability, and efficiency of the automated method with manually derived ACS using expert observers as benchmarks. The results showed that the automated approach was more accurate in identifying anatomical landmarks, with smaller mean distance discrepancies (0.6 mm) than manual observers (1 mm). Its reproducibility was also superior, with narrower reproducibility limits, particularly for ulnar notch landmarks (0.6 to 0.8 mm compared to manual selection 1.2 to 1.4 mm) (p = .01). In addition, the limits of agreement and the mean absolute rotational and translational differences of the axes were narrower for the automated method, which also reduced the construction time to an average of 46 s compared to 150 s manually (p < .001). These findings suggest that the automated method has the potential to enhance the accuracy and efficiency of preoperative and postoperative computer‐assisted procedures for RHA. Further research is needed to fully understand the utility of this automated system for enhancing RHA computer‐assisted surgical planning.

Objective: Despite excellent functional outcomes after shoulder stabilization surgery, a substantial number of patients fail to return to sports (RTS) at the preinjury level. The psychological factors affecting RTS postsurgery have been underexplored. This scoping review aimed to identify and analyze potential psychological factors influencing the decision to RTS after shoulder stabilization surgery. Data Sources: We reviewed the EBSCOhost/SPORTDiscus, PubMed/Medline, Scopus, EMBASE, and Cochrane Library databases for studies on patients with anterior glenohumeral instability who underwent stabilization surgery. We included studies that reported on RTS and considered the psychological factors influencing the decision to return. Main Results: Our analysis comprised 21 articles involving 2073 patients. Psychological factors influencing RTS after surgery were categorized within the framework of transactional stress and coping model. Primary appraisal factors, such as fear of reinjury, kinesiophobia, and anxiety, emerged as significant influencers. In addition, we explored factors related to social support, self-determination, motivation, competing interests, and advanced age. Assessment tools were used to evaluate the psychological readiness for RTS. Conclusions: This scoping review identified fear of reinjury and kinesiophobia as important psychological barriers to returning to sports after shoulder stabilization surgery. The limited use of psychological assessment tools and lack of comparative studies have restricted robust conclusions. Level of Evidence: Level IV, Scoping review.