Browsing by Author "Sánchez-Sotelo, Joaquín"

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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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    Mid- to long-term outcomes of latissimus dorsi tendon transfer for massive irreparable posterosuperior rotator cuff tears: a systematic review and meta-analysis
    (2023) Velásquez García, Ausberto; Nieboer, Micah J.; Marinis Acle, Rodrigo Ignacio de; Morrey, Mark E.; Valenti, Philippe; Sánchez-Sotelo, Joaquín
    Background: This study aims to analyze the mid- to long-term results of the latissimus dorsi tendon for the treatment of massive posterosuperior irreparable rotator cuff tears as reported in high-quality publications and to determine its efficacy and safety.Methods: A systematic review was performed according to the PRISMA guidelines. PubMed, Scopus, and EMBASE databases were searched until December 2022 to identify studies with a minimum 4-year follow-up. Clinical and radiographic outcomes, complications, and revision surgery data were collected. The publications included were analyzed quantitatively using the DerSimonian Laird random-effects model to estimate the change in outcomes from the preoperative to the postoperative condition. The proportion of complications and revisions were pooled using the Freeman-Tukey double arcsine transformation.Results: Of the 618 publications identified through database search, 11 articles were considered eligible. A total of 421 patients (432 shoulders) were included in this analysis. Their mean age was 59.5 ± 4 years. Of these, 277 patients had mid-term follow-up (4 to 9 years), and 144 had long-term follow-up (more than 9 years). Postoperative improvements were considered significant for the following outcome parameters: Constant-Murley Score (0-100 scale), with a mean difference (MD) = 28 points (95% CI 21, 36; I2= 89%; P<.001); visual analog scale, with a standardized MD = 2.5 (95%CI 1.7, 3.3; P<.001; I2= 89%; P<.001); forward flexion, with a MD = 43° (95% CI 21°, 65°; I2=95% P<.001); abduction, with a MD = 38° (95% CI 20°, 56°; I2=85%; P < .01), and external rotation, with a MD = 8° (95% CI 1°, 16°; I2=87%; P= .005). The overall reported mean complication rate was 13% (95% CI 9%, 19%; I2=0%), while the reported mean revision rate was 6% (95% CI: 3%, 9%; I2=0%).Conclusions: Our pooled estimated results seem to indicate that latissimus dorsi tendon transfer significantly improves patient-reported outcomes, pain relief, range of motion, and strength, with modest rates of complications and revision surgery at mid- to long-term follow-up. In well-selected patients, latissimus dorsi tendon transfer may provide favorable outcomes for irreparable posterosuperior cuff tears.
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    Venous Thromboembolism Following Surgical Management of Proximal Humerus Fractures: A Systematic Review
    (2023) Marigi, Erick M.; Sperling, John W.; Marinis Acle, Rodrigo Ignacio de; Gupta, Puneet; Hassett, Leslie C.; Soza Rex Jose Francisco; Sánchez-Sotelo, Joaquín
    Currently, there is limited information on the incidence of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) after surgical treatment of proximal humerus fractures (PHFs). Therefore, the purpose of this systematic review is to evaluate the incidence of VTE, DVT, and PE following surgery for PHFs.