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CT-Based Patient-Specific Modeling of Glenoid Rim Defects: A Feasibility Study

¹ Department of Radiology, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Chariteplatz 1, Berlin, Germany 10117.
² Department of Radiology, Musculoskeletal and Quantitative Imaging Research Group, University of California, San Francisco, San Francisco, CA.
³ Department of Visualization and Data Analysis, Medical Planning Group, Zuse-Institute Berlin, Berlin, Germany.
⁴ Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Charité Campus Virchow, Berlin, Germany.

View larger version (50K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —Three-dimensional surface renderings from CT scans for analysis of glenoid parameters in 25-year-old man with normal glenoid from control group. Largest length of glenoid joint surface was measured from top to bottom (blue line) and in anteroposterior direction (red line) in en face view of articular surface.

View larger version (58K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —Three-dimensional surface renderings from CT scans for analysis of glenoid parameters in 25-year-old man with normal glenoid from control group. Area for measuring surface area was defined along outer bony edge of glenoid rim.

View larger version (53K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —Three-dimensional surface renderings from CT scans for analysis of glenoid parameters in 25-year-old man with normal glenoid from control group. For measurement of glenoid volume, articular body was aligned parallel to joint surface and separated medially at distance of 10 mm (red line) from joint edge.

View larger version (52K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —Three-dimensional surface renderings from CT scans for analysis of glenoid parameters in 25-year-old man with normal glenoid from control group. Cranially, highest point of edge of joint socket defined plane for separation from coracoid process.

View larger version (43K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Virtual glenoid rim reconstruction from CT scans in study group after fracture creation. Image of right-sided glenoid (A) shows defect in anterior edge. Contralateral glenoid (B) is intact. First, intact glenoid is mirrored vertically. Next, joint areas of two glenoid bodies are aligned and projected into each other (C). In this way former glenoid rim defect is filled with intact contralateral side (C and D). To determine precision of reconstruction procedure (E), reconstructed glenoid (blue and red) was superimposed on prefracture image (yellow).

View larger version (46K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Virtual glenoid rim reconstruction from CT scans in study group after fracture creation. Image of right-sided glenoid (A) shows defect in anterior edge. Contralateral glenoid (B) is intact. First, intact glenoid is mirrored vertically. Next, joint areas of two glenoid bodies are aligned and projected into each other (C). In this way former glenoid rim defect is filled with intact contralateral side (C and D). To determine precision of reconstruction procedure (E), reconstructed glenoid (blue and red) was superimposed on prefracture image (yellow).

View larger version (45K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —Virtual glenoid rim reconstruction from CT scans in study group after fracture creation. Image of right-sided glenoid (A) shows defect in anterior edge. Contralateral glenoid (B) is intact. First, intact glenoid is mirrored vertically. Next, joint areas of two glenoid bodies are aligned and projected into each other (C). In this way former glenoid rim defect is filled with intact contralateral side (C and D). To determine precision of reconstruction procedure (E), reconstructed glenoid (blue and red) was superimposed on prefracture image (yellow).

View larger version (52K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —Virtual glenoid rim reconstruction from CT scans in study group after fracture creation. Image of right-sided glenoid (A) shows defect in anterior edge. Contralateral glenoid (B) is intact. First, intact glenoid is mirrored vertically. Next, joint areas of two glenoid bodies are aligned and projected into each other (C). In this way former glenoid rim defect is filled with intact contralateral side (C and D). To determine precision of reconstruction procedure (E), reconstructed glenoid (blue and red) was superimposed on prefracture image (yellow).

View larger version (54K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2E —Virtual glenoid rim reconstruction from CT scans in study group after fracture creation. Image of right-sided glenoid (A) shows defect in anterior edge. Contralateral glenoid (B) is intact. First, intact glenoid is mirrored vertically. Next, joint areas of two glenoid bodies are aligned and projected into each other (C). In this way former glenoid rim defect is filled with intact contralateral side (C and D). To determine precision of reconstruction procedure (E), reconstructed glenoid (blue and red) was superimposed on prefracture image (yellow).

View larger version (34K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —Virtual created model of bony defect (missing bone fragment) derived from CT scans in study group. After superimposition of fractured with intact contralateral glenoid, resulting fragment can be separated and measured. Lateral view (en face) (A), posterior view (B), anterior view (C), and medial view (D) are shown.

View larger version (33K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —Virtual created model of bony defect (missing bone fragment) derived from CT scans in study group. After superimposition of fractured with intact contralateral glenoid, resulting fragment can be separated and measured. Lateral view (en face) (A), posterior view (B), anterior view (C), and medial view (D) are shown.

View larger version (37K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —Virtual created model of bony defect (missing bone fragment) derived from CT scans in study group. After superimposition of fractured with intact contralateral glenoid, resulting fragment can be separated and measured. Lateral view (en face) (A), posterior view (B), anterior view (C), and medial view (D) are shown.

View larger version (30K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —Virtual created model of bony defect (missing bone fragment) derived from CT scans in study group. After superimposition of fractured with intact contralateral glenoid, resulting fragment can be separated and measured. Lateral view (en face) (A), posterior view (B), anterior view (C), and medial view (D) are shown.

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