Friday, May 06, 2011

How to read X-ray after the TSA (total shoulder arthroplasty)

Shoulder Replacement  is uncommon compared to hips and knees,. Presently 3 types classical modular, inverse and Cup varieties. Another way of differentiating various types are Hemiarthroplasty,Total and Reverse Total replacements.
How to read X-ray after the TSA(total shoulder arthroplasty).
Teaching point by Dr MGK Murthy

Technique: True AP and Axial projections mandatory

Look for
(a) Type of the prosthesis and components used
(b) Alignment
(c) Radiolucent lines along the humeral component
(d) Exact visualization of the interface between the glenoid component and bone (or cement-bone interface) along with similar bone and implant interface in humeral component is important to study osteolysis which is common
(e) Glenoid component is usually fixed by screws to the bone and an osteolysis is often present at the inferior pole of the glenoid component due to prosthesis bone notching.
(f) Dissociation between components is to be mentioned including dislocations
(g) Any other unusual events like in other joint replacements



This is a middle aged person with history of shoulder replacement surgery for rheumatoid arthritis for routine post procedure X-ray shows

(a) The position of the prosthesis (apparently total shoulder replacement ) is satisfactory
(b) Interface between bone and cement in both glenoid and humeral component is normal
(c) No loosening
(d) No significant soft tissue heterotopic ossification, thought he minimal spiky opacity at the caudal end of the humeral stem is possibly reactive new bone formation
(e) No significant osteolysis






1 comment:

Global Hospitals said...

Good way of explanation about reading the X-ray after TSA. But it would be more effective if explained in some more brief manner. X-ray gives clear idea about the lower part of the body.

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