scholarly journals Novel 3-dimensionally printed patient-specific guide improves accuracy compared with standard total shoulder arthroplasty guide: a cadaveric study

2019 ◽  
Vol 3 (2) ◽  
pp. 83-92 ◽  
Author(s):  
Brandon C. Cabarcas ◽  
Gregory L. Cvetanovich ◽  
Alejandro A. Espinoza Orías ◽  
Nozomu Inoue ◽  
Anirudh K. Gowd ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Cadaveric Study ◽  
Patient Specific

scholarly journals Journey of the glenoid in anatomic total shoulder replacement

2018 ◽  
Vol 11 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alessandro Castagna ◽  
Raffaele Garofalo
Keyword(s):  
Shoulder Arthroplasty ◽  
Current Practice ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Patient Specific ◽  
Glenoid Component ◽  
Shoulder Replacement ◽  
Final Destination ◽  
Component Loosening

Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function. Over the years, different glenoid design and materials have been tried in various configurations. These include cemented polyethylene, uncemented metal-backed and hybrid implants. Although advances in biomechanics, design and tribology have improved our understanding of the glenoid, the journey of the glenoid component in anatomic total shoulder arthroplasty has not yet reached its final destination. This article attempts to describe the evolution of the glenoid component in anatomic TSR and current practice.

Preoperative three-dimensional computer planning for reverse total shoulder arthroplasty and bone grafting for severe glenoid deformity

2020 ◽  
pp. 175857322090890
Author(s):  
Robert Z Tashjian ◽  
Lindsay Beck ◽  
Irene Stertz ◽  
Peter N Chalmers
Keyword(s):  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation ◽  
Reverse Total Shoulder ◽  
Glenoid Erosion

Background Computer assisted planning without patient specific instrumentation may be utilized to guide reverse total shoulder arthroplasty baseplate placement. The purpose of this study was to determine the difference between planned and achieved inclination and retroversion correction with three-dimensional preoperative computer assisted planning in reverse total shoulder arthroplasty without patient specific instrumentation with bone grafting for severe glenoid erosion. Methods Preoperative three-dimensional computer assisted planning without patient specific instrumentation was performed on 15 patients undergoing primary reverse total shoulder arthroplasty with glenoid bone grafting for severe glenoid erosion. On preoperative and immediate postoperative computed tomography slices, two-dimensional retroversion and inclination were measured. Preoperative three-dimensional baseline retroversion and inclination and planned postoperative three-dimensional retroversion and inclination were measured. Planned and achieved version and inclination changes were compared. Results The planned and achieved retroversion corrections were 18° and 12°, respectively (p < 0.001). The planned and achieved inclination corrections were 11° and 11°, respectively (p = 0.803). Conclusions Three-dimensional computer assisted planning without patient specific instrumentation in the setting of reverse total shoulder arthroplasty with severe glenoid erosion requiring bone grafting can accurately guide baseplate placement. All cases in which failure to correct retroversion or inclination within 10° of planning occurred in patients with severe erosion (B3 or E3 glenoids), therefore patient specific guides may be warranted in these cases to improve accuracy of implantation. Level of evidence Level IV, retrospective case series.

Nerve stress during reverse total shoulder arthroplasty: a cadaveric study

2017 ◽  
Vol 26 (2) ◽  
pp. 323-330 ◽  
Author(s):  
Hubert Lenoir ◽  
Louis Dagneaux ◽  
François Canovas ◽  
Thomas Waitzenegger ◽  
Thuy Trang Pham ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Cadaveric Study ◽  
Reverse Total Shoulder

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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