Computer-Assisted Preoperative Planning and Patient-Specific Instrumentation for Glenoid Implants in Shoulder Arthroplasty

JBJS Reviews ◽  
2021 ◽  
Vol 9 (9) ◽  
Author(s):  
James G. Levins ◽  
Mohit Kukreja ◽  
E. Scott Paxton ◽  
Andrew Green
Keyword(s):  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation

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 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

Sign in / Sign up

Export Citation Format

Share Document