scholarly journals Evaluation of Accuracy and Reproducibility of Patient-specific Guides Using 3-dimensional Reconstruction in Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 22 (1) ◽  
pp. 1-2
Author(s):  
Sae Hoon Kim
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
3 Dimensional ◽  
Dimensional Reconstruction ◽  
Reverse Total Shoulder

scholarly journals Patient-specific Guides Using 3-dimensional Reconstruction Provide Accuracy and Reproducibility in Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 22 (1) ◽  
pp. 16-23
Author(s):  
Jong Pil Yoon ◽  
Dong Hyun Kim ◽  
Jae Wook Jung ◽  
Chang-Hwa Lee ◽  
Seunggi Min ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Conventional Group ◽  
Patient Specific ◽  
Glenoid Component ◽  
3 Dimensional ◽  
Humeral Component ◽  
Dimensional Reconstruction ◽  
Reverse Total Shoulder

Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components.Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image.Results: The superoinferior and anteroposterior offset in the glenoid component were 0.42 ± 0.07, 0.50 ± 0.08 in the conventional group and 0.45 ± 0.03, 0.46 ± 0.02 in the PSG group. The inclination and version angles were -1.93° ± 4.31°, 2.27° ± 5.91° and 0.46° ± 0.02°, 3.38° ± 2.79°. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were 0.45 ± 0.12, 0.48 ± 0.15 in the conventional group and 0.46 ± 0.59 (<i>p</i>=0.794), 0.46 ± 0.06 (<i>p</i>=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment.Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.

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 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 Complications of Reverse Total Shoulder Arthroplasty: A Computational Modelling Perspective

2021 ◽  
Vol 10 (22) ◽  
pp. 5336
Author(s):  
Yichen Huang ◽  
Lukas Ernstbrunner ◽  
Dale L. Robinson ◽  
Peter Vee Sin Lee ◽  
David C. Ackland
Keyword(s):  
Computational Modeling ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Computational Modelling ◽  
Revision Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Patient Specific ◽  
Shoulder Biomechanics ◽  
Reverse Total Shoulder

Reverse total shoulder arthroplasty (RTSA) is an established treatment for elderly patients with irreparable rotator cuff tears, complex proximal humerus fractures, and revision arthroplasty; however, with the increasing indications for RTSA over the last decade and younger implant recipients, post-operative complications have become more frequent, which has driven advances in computational modeling and simulation of reverse shoulder biomechanics. The objective of this study was to provide a review of previously published studies that employed computational modeling to investigate complications associated with RTSA. Models and applications were reviewed and categorized into four possible complications that included scapular notching, component loosening, glenohumeral joint instability, and acromial and scapular spine fracture, all of which remain a common cause of significant functional impairment and revision surgery. The computational shoulder modeling studies reviewed were primarily used to investigate the effects of implant design, intraoperative component placement, and surgical technique on postoperative shoulder biomechanics after RTSA, with the findings ultimately used to elucidate and mitigate complications. The most significant challenge associated with the development of computational models is in the encapsulation of patient-specific anatomy and surgical planning. The findings of this review provide a basis for future direction in computational modeling of the reverse shoulder.

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review

2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Revisional Surgery ◽  
Total Shoulder Arthroplasty ◽  
Surgical Site Infections ◽  
Total Sample ◽  
Reverse Total Shoulder Arthroplasty ◽  
Common Complication ◽  
Humeral Component ◽  
Reverse Total Shoulder

Background Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening. Methods This systematic review adhered to PRISMA reporting guideline. For our inclusion criteria, we included any study that contained intraoperative and/or postoperative complication data, and revision rates on patients who had undergone revision reverse total shoulder arthroplasty due to a failed hemiarthroplasty. Complications include neurologic injury, deep surgical site infections, hardware loosening/prosthetic instability, and postoperative fractures (acromion, glenoid, and humeral fractures). Results The study contained 22 studies that assessed complications from shoulders that had revision reverse total shoulder arthroplasty from a hemiarthroplasty, with a total sample of 925 shoulders. We found that the most common complication to occur was hardware loosenings (5.3%), and of the hardware loosenings, humeral loosenings (3.8%) were the most common. The revision rate was found to be 10.7%. Conclusion This systematic review found that revision reverse total shoulder arthroplasty for failed hemiarthroplasty has a high overall complication and reintervention rates, specifically for hardware loosening and revision rates.

Sign in / Sign up

Export Citation Format

Share Document