Computer navigation leads to more accurate glenoid targeting during total shoulder arthroplasty compared with 3-dimensional preoperative planning alone

2020 ◽  
Vol 29 (11) ◽  
pp. 2257-2263 ◽  
Author(s):  
Bradley S. Schoch ◽  
Edward Haupt ◽  
Thiago Leonor ◽  
Kevin W. Farmer ◽  
Thomas W. Wright ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Computer Navigation ◽  
3 Dimensional

scholarly journals Eccentric Reaming for B2 Glenoids: History, Preoperative Planning, Surgical Technique, and Outcome

2019 ◽  
Vol 3 ◽  
pp. ???
Author(s):  
Matthew J Smith ◽  
Christopher M Loftis ◽  
Nathan W Skelley
Keyword(s):  
Surgical Technique ◽  
Cortical Bone ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Joint Line ◽  
Neutral Position ◽  
Anterior Portion ◽  
Surgical Options

Background The biconcave (B2) glenoid is characterized by preservation of the anterior portion of the native glenoid with asymmetric wear of the posterior glenoid. Surgical options for glenoid correction have evolved. The goal of shoulder arthroplasty is to place the implants in such a manner to return the humeral head to a centered position and restore the joint line to a neutral position. There is no current consensus on method of treatment and correction. Methods The current and historical literature on total shoulder arthroplasty was used to examine technique viability. Results Asymmetric remaining can be used to address up to 15° of version correction without compromise of cortical bone. It is important to have the proper presurgical planning, to understand the limitations of correction, and to have other options available to treat the biconcave glenoid.

Sequential 3-dimensional computed tomography analysis of implant position following total shoulder arthroplasty

2018 ◽  
Vol 27 (6) ◽  
pp. 983-992 ◽  
Author(s):  
Eric T. Ricchetti ◽  
Bong-Jae Jun ◽  
Richard A. Cain ◽  
Ari Youderian ◽  
Eric J. Rodriguez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Implant Position ◽  
3 Dimensional ◽  
Tomography Analysis

scholarly journals Clinical Use of a Computer Assisted Reverse Total Shoulder Arthroplasty System: an Analysis of 1702 Cases

10.29007/hcd6 ◽  
2019 ◽  
Author(s):  
Alexander Greene ◽  
Sandrine Polakovic ◽  
Christopher Roche ◽  
Yifei Dai
Keyword(s):  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Computer Assisted Surgery ◽  
Reverse Total Shoulder Arthroplasty ◽  
Computer Assisted ◽  
Glenoid Component ◽  
Implant Placement ◽  
Implant Selection ◽  
Reverse Total Shoulder

Placement of the glenoid component in reverse total shoulder arthroplasty (rTSA) is of paramount importance and can affect a patient’s range of motion postoperatively. Preoperative planning and computer assisted surgery (CAS) can improve upon glenoid placement, but such systems for rTSA have experienced limited commercial success. Postoperative surgical reports from the first 1702 clinical cases of a commercially available CAS rTSA system were collected and analyzed for implant selection, implant placement, and incision start to incision close operative time, and compared to similar date cohorts for non-navigated cases. Navigated rTSA cases had a significantly longer incision time than non-navigated cases. Augmented glenoid components were used in a much higher percentage of navigated cases than non-navigated cases, suggesting that augmented glenoid components provide utility for correcting pathologic glenoid wear. The average resultant version and inclination of the implanted component increased with the size of augment used, suggesting there may not be a clear consensus on optimal version or inclination. Long term clinical follow up will need to be collected to determine if preoperative planning combined with more precise and accurate glenoid component positioning leads to improved clinical outcomes and implant longevity.

scholarly journals An update on reverse total shoulder arthroplasty: current indications, new designs, same old problems

2021 ◽  
Vol 6 (3) ◽  
pp. 189-201
Author(s):  
Thomas Kozak ◽  
Stefan Bauer ◽  
Gilles Walch ◽  
Saad Al-karawi ◽  
William Blakeney
Keyword(s):  
Shoulder Arthroplasty ◽  
Mixed Reality ◽  
Total Shoulder Arthroplasty ◽  
Computer Navigation ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Shoulder Replacement ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Reverse Total Shoulder

Reverse total shoulder arthroplasty (RTSA) was originally developed because of unsatisfactory results with anatomic shoulder arthroplasty options for the majority of degenerative shoulder conditions and fractures. After initial concerns about RTSA longevity, indications were extended to primary osteoarthritis with glenoid deficiency, massive cuff tears in younger patients, fracture, tumour and failed anatomic total shoulder replacement. Traditional RTSA by Grammont has undergone a number of iterations such as glenoid lateralization, reduced neck-shaft angle, modular, stemless components and onlay systems. The incidence of complications such as dislocation, notching and acromial fractures has also evolved. Computer navigation, 3D planning and patient-specific implantation have been in use for several years and mixed-reality guided implantation is currently being trialled. Controversies in RTSA include lateralization, stemless humeral components, subscapularis repair and treatment of acromial fractures. Cite this article: EFORT Open Rev 2021;6:189-201. DOI: 10.1302/2058-5241.6.200085

scholarly journals Automatic muscle elongation measurement during shoulder arthroplasty planning

10.29007/hwz8 ◽  
2020 ◽  
Author(s):  
Jonathan Pitocchi ◽  
Katrien Plessers ◽  
Mariska Wesseling ◽  
G. Harry van Lenthe ◽  
Maria Angeles Pérez
Keyword(s):  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Muscle Length ◽  
Postoperative Outcome ◽  
Patient Specific ◽  
Shape Modelling ◽  
Large Variability ◽  
Promising Tool ◽  
Specific Muscle

Adequate deltoid and rotator cuff lengthening in total shoulder arthroplasty (TSA) is crucial to maximize the postoperative functional outcome and to avoid complications. Hence surgeons and patients could benefit from including muscle length information in preoperative planning software.Although different methods have been introduced to automatically indicate patient-specific muscle attachment and wrapping points, the definition of a fast and accurate workflow is still a challenge, due to the large variability in bone shapes. Therefore, the goal of this study is to develop and evaluate the accuracy of a novel method to automatically estimate muscle elongation, based on a statistical shape modelling (SSM) approach.Firstly, humerus and scapula SSMs were used to automatically indicate the attachment points of the main shoulder muscles: subscapularis, supraspinatus, infraspinatus, teres minor and deltoid. Secondly, a wrapping algorithm was applied to identify the points where muscles wrap around bones or potential implants. Finally, the accuracy of the automatically indicated landmarks and its effect on the muscle elongation were evaluated by comparing the manually indicated landmarks with the landmarks identified through the SSM for a set of 40 healthy shoulder CT-scans.The low errors on elongation values suggest that the presented automated workflow is a promising tool for allowing surgeons to evaluate patient-specific muscle elongations during preoperative planning. Although the evaluation was limited to healthy joints, this method allows to easily process large datasets and to potentially find a correlation between muscle elongations and postoperative outcome.

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