Browsing by Author "Marigi, Erick"

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    Artificial intelligence to automatically measure glenoid inclination, humeral alignment, and the lateralization and distalization shoulder angles on postoperative radiographs after reverse shoulder arthroplasty
    (Elsevier Inc., 2024) Linjun, Yang; De Marinis Acle, Rodrigo Ignacio; Yu, Kristin; Marigi, Erick; Oeding, Jacob F.; Sperling, John W.; Sánchez-Sotelo, Joaquín
    Background: Radiographic evaluation of the implant configuration after reverse shoulderarthroplasty (RSA) is time-consuming and subject to interobserver disagreement. The finalconfiguration is a combination of implant features and surgical execution. Artificial intel ligence (AI) algorithms have been shown to perform accurate and efficient analysis ofimages. The purpose of this study was to develop an AI algorithm to automatically measureglenosphere inclination, humeral component inclination, and the lateralization and dis talization shoulder angles (DSAs) on postoperative anteroposterior radiographs after RSA.Methods: The Digital Imaging and Communications in Medicine files corresponding topostoperative anteroposterior radiographs obtained after implantation of 143 RSAs wereretrieved and used in this study. Four angles were analyzed: (1) glenoid inclination angle(GIA, between the central fixation feature of the glenoid and the floor of the supraspinatusfossa), (2) humeral alignment angle (HAA, between the long axis of the humeral shaft and aperpendicular to the metallic bearing of the prosthesis), (3) DSA, and (4) lateralizationshoulder angle (LSA). A UNet segmentation model was trained to segment bony and implant elements using manually segmented training (n ¼ 89) and validation (n ¼ 22) images. Then, an image-processingebased pipeline was developed to measure all 4 angles using AI-segmented images. Measures performed by 3 physician observers and the AI algorithm were then completed in 32 additional images. The agreements among human observers and between observers and the AI algorithm were evaluated using intraclass correlation coefficients (ICCs) and absolute differences in degree. Results: The ICCs (95% confidence interval) for manual measurements of LSA, DSA, GIA, and HAA were 0.79 (0.55, 0.90), 0.90 (0.80, 0.95), 0.96 (0.93, 0.98), and 0.99 (0.97, 0.99), respectively. The AI algorithm measured the 32 images in the test set in less than 2 minutes. The agreement between observers and the AI algorithm was lowest when measuring the LSA for observer 2, with an ICC of 0.77 (0.52, 0.89), and an absolute difference in degrees (median [interquartile range]) of 5 (4). Better agreements were found between the AI measurements and the average manual measurements: absolute differences in degree for LSA, DSA, GIA, and HAA were 3 (5), 2 (3), 2 (2), and 2 (1), respectively; ICCs for LSA, DSA, GIA, and HAA were 0.89 (0.79, 0.95), 0.96 (0.93, 0.98), 0.85 (0.68, 0.93), and 0.98 (0.95, 0.99), respectively. Conclusion: The AI algorithm developed in this study can automatically measure the GIA, HAA, LSA, and DSA on postoperative anteroposterior radiographs obtained after implantation on RSA.
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    Lower Trapezius Transfer Improves Clinical Outcomes With a Rate of Complications and Reoperations Comparable to Other Surgical Alternatives in Patients with Functionally Irreparable Rotator Cuff Tears: A Systematic Review
    (2023) Marinis Acle, Rodrigo Ignacio de; Marigi, Erick; Atwan, Yousif; Velásquez García, Ausberto; Morrey, Mark E.; Sánchez Sotelo, Joaquin
    Purpose To analyze the clinical outcomes of lower trapezius transfer (LTT) for patients with functionally irreparable rotator cuff tears (FIRCT) and summarize the available literature regarding complications and reoperations. Methods After registration in the International prospective register of systematic reviews(PROSPERO [CRD42022359277]), a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Inclusion criteria were English, full-length, peer-reviewed publications with a level of evidence IV or higher reporting on clinical outcomes of LTT for FIRCT. Ovid MEDLINE(R), Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus via Elsevier databases were searched. Clinical data, complications and revisions were systematically recorded. Results Seven studies with 159 patients were identified. The mean age range was 52 – 63 years, 70.4% of the patients included were male, and the mean follow-up time ranged between 14 and 47 months. At final follow-up, LTT lead to improvements in range of motion (ROM), with reported forward elevation (FE) and external rotation (ER) mean gains of 10º – 66º and 11º – 63º, respectively. ER lag was present preoperatively in 78 patients and was reversed after LTT in all shoulders. Patient reported outcomes were improved at final follow-up, including the American Shoulder and Elbow Society score, Shoulder Subjective Value and Visual Analogue Scale. The overall complication rate was 17.6% and the most reported complication was posterior harvest site seroma/hematoma (6.3%). The most common reoperation was conversion to reverse shoulder arthroplasty (5%) with an overall reoperation rate of 7.5%. Conslusions Lower trapezius transfer improves clinical outcomes in patients with irreparable rotator cuff tears with a rate of complications and reoperations comparable to other surgical alternatives in this group of patients. Increases in FF and ER are to be expected, as well as a reversal of ER lag sign when preoperatively present. Level of Evidence Level IV, a systematic review of Level III-IV studies.