Researchers at Emory Healthcare have used dynamic digital radiography (DDR) to analyze shoulder biomechanics in patients with massive irreparable rotator cuff tears (MIRCTs), comparing outcomes from two commonly used surgical interventions: reverse shoulder arthroplasty (RSA) and arthroscopically assisted lower trapezius tendon (aLTT) transfer.

Led by Dr. Sameer R. Khawaja, and Dr. Eric R. Wagner, the Emory team found that patients who underwent aLTT experienced improved shoulder biomechanics and stability compared to those who received RSA. While RSA remains a widely accepted option for treating MIRCTs, the study concluded it does not replicate the native mechanics of the shoulder to the same extent as aLTT.

DDR is a low-dose X-ray technique that captures a sequence of high-speed images, generating a cineloop that displays joint movement over time. Available on systems from Konica Minolta Healthcare Americas Inc., DDR allows clinicians to assess musculoskeletal motion noninvasively.
The study, published online and in press with the Journal of Shoulder and Elbow Surgery, leveraged DDR to capture in vivo scapulohumeral rhythm (SHR)—a measure of the coordination between glenohumeral and scapulothoracic joint movement. By evaluating changes in SHR before and after surgery, researchers sought to establish a more objective basis for determining which surgical approach offers better restoration of shoulder function.

“Using the dynamic radiography provided by Konica Minolta’s DDR imaging enables us to change the clinical algorithms for both preoperative decision making and postoperative evaluations of surgical outcomes,” Wagner said.

Orthopedic surgery resident Zaamin Hussain, M.D., noted the challenge in selecting between RSA and aLTT: “Not only can the DDR images help make that decision preoperatively, but the results of this study suggest there is potential for improved overall coordination of the shoulder with aLTT.”

The research underscores DDR’s role in evaluating postsurgical outcomes and supporting evidence-based surgical decisions in shoulder reconstruction.

X-Ray Homepage