scholarly journals Preoperative glenoid considerations for shoulder arthroplasty: a review

2020 ◽  
Vol 5 (3) ◽  
pp. 126-137
Author(s):  
Stephen Gates ◽  
Brain Sager ◽  
Michael Khazzam
Keyword(s):  
Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Preoperative Assessment ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation ◽  
3D Ct Scan ◽  
Implant Survivorship ◽  
Patient Reported ◽  
Glenoid Morphology

Preoperative assessment of the glenoid in the setting of shoulder arthroplasty is critical to account for variations in glenoid morphology, wear, version, inclination, and glenohumeral subluxation. Three-dimensional computed tomography (3D CT) scan assessment of the morphology of glenoid erosion allows for a more accurate surgical decision-making process to correct deformity and restore the joint line. Newer technology has brought forth computer-assisted software for glenoid planning in shoulder arthroplasty and patient-specific instrumentation. There have been promising early findings, although further evaluation is needed to determine how this technology impacts implant survivorship, function, and patient-reported outcomes. Cite this article: EFORT Open Rev 2020;5:126-137. DOI: 10.1302/2058-5241.5.190011

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.

scholarly journals Patient-Specific Instrumentation Accuracy Evaluated with 3D Virtual Models

2021 ◽  
Vol 10 (7) ◽  
pp. 1439
Author(s):  
Vicente J. León-Muñoz ◽  
Andrea Parrinello ◽  
Silvio Manca ◽  
Gianluca Galloni ◽  
Mirian López-López ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Three Dimensional ◽  
Dimensional Accuracy ◽  
Tibial Slope ◽  
Patient Specific ◽  
Virtual Models ◽  
Relevant Effect ◽  
Patient Specific Instrumentation ◽  
Significant Difference ◽  
Patient Reported

There have been remarkable advances in knee replacement surgery over the last few decades. One of the concerns continues to be the accuracy in achieving the desired alignment. Patient-specific instrumentation (PSI) was developed to increase component placement accuracy, but the available evidence is not conclusive. Our study aimed to determine a PSI system’s three-dimensional accuracy on 3D virtual models obtained by post-operative computed tomography. We compared the angular placement values of 35 total knee arthroplasties (TKAs) operated within a year obtained with the planned ones, and we analyzed the possible relationships between alignment and patient-reported outcomes. The mean (SD) discrepancies measured by two experienced engineers to the planned values observed were 1.64° (1.3°) for the hip–knee–ankle angle, 1.45° (1.06°) for the supplementary angle of the femoral lateral distal angle, 1.44° (0.97°) for the proximal medial tibial angle, 2.28° (1.78°) for tibial slope, 0.64° (1.09°) for femoral sagittal flexion, and 1.42° (1.06°) for femoral rotation. Neither variables related to post-operative alignment nor the proportion of change between pre-and post-operative alignment influenced the patient-reported outcomes. The evaluated PSI system’s three-dimensional alignment analysis showed a statistically significant difference between the angular values planned and those obtained. However, we did not find a relevant effect size, and this slight discrepancy did not impact the clinical outcome.

scholarly journals Computer-Assisted Planning and Three-Dimensional-Printed Patient-Specific Instrumental Guide for Corrective Osteotomy in Post-Traumatic Femur Deformity: A Case Report and Literature Review

2018 ◽  
Vol 24 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Lau Chi-Kay ◽  
Chui King-him ◽  
Lee Kin-bong ◽  
Li Wilson
Keyword(s):  
Lower Limb ◽  
New Technologies ◽  
Preoperative Planning ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Limb Deformity ◽  
Satisfactory Outcome ◽  
Post Traumatic

Post-traumatic limb deformity is often multiplanar and thus is a difficult pathology to deal with surgically. Precise preoperative planning and accurate intraoperative execution are two main important steps that lead to satisfactory outcome. Computer-assisted planning and three-dimensional-printed patient-specific instrumental guides provide excellent aid to the two steps, respectively. We report a case of posttraumatic lower limb deformity in a patient who underwent closing wedge corrective osteotomy with the aid of the aforementioned new technologies.

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