Bone quality in total shoulder arthroplasty: a prospective study correlating computed tomography Hounsfield units with thumb test and fracture risk assessment tool score

• DOI: 10.1016/j.jseint.2023.03.012
• Publication Date: 2023-04-12T16:27:28Z
• Authors: Alexander Hayden; Eric J. Cotter; Terah Hennick; Scott Hetzel; John Wollaeger; Scott Anderson; Brian F. Grogan
• Keywords: Hounsfield scale

To evaluate if Hounsfield units (HU) measured on preoperative computed tomography (CT) scans at the anatomic neck of proximal humerus correlates with intraoperative findings "thumb test" in assessment bone quality shoulder arthroplasty patients.Primary total and reverse patients from 2019-2022 an available CT scan operative were prospectively enrolled a single center 3 surgeons who perform arthroplasty. The was performed intraoperatively; positive test signified "good bone." Demographic information, including prior dual x-ray absorptiometry scans, extracted medical record. HU cut surface calculated, as cortical thickness CT. Fracture risk tool (FRAX) scores calculated for 10-year osteoporotic fracture.A 149 enrolled. Mean age 67.6 ± 8.5 years 69 (46.3%) being males. Patients negative thumb significantly older (72.3 6.6 vs. 66.5 8.6 years; P < .001) than those test. Males more likely to have females (P = .014). had lower HUs (16.3 29.7 51.9 35.2; .001). higher mean FRAX score (14.1 7.9 8.0 4.8; Receiver operator curve analysis identify cut-off value 36.67, above which is be positive. Furthermore, receiver also identified optimal values fracture by 7.75 HU, below Fifty high based HU; classified 21 (42%) having "poor bone" through High-risk 33.8% (23/68) 37.1% (26/71) time FRAX, respectively.Surgeons are poor identifying suboptimal when referencing against scores. objective measures scoring may useful metrics incorporate into surgeons' plans humeral stem fixation using readily imaging demographic data.