TY - JOUR
T1 - Preoperative planning for accurate glenoid component positioning in reverse shoulder arthroplasty
AU - Berhouet, J.
AU - Gulotta, L. V.
AU - Dines, D. M.
AU - Craig, E.
AU - Warren, R. F.
AU - Choi, D.
AU - Chen, X.
AU - Kontaxis, A.
N1 - Publisher Copyright:
© 2017
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Background Glenoid component positioning in reverse shoulder arthroplasty (RSA) is challenging. Patient-specific instrumentation (PSI) has been advocated to improve accuracy, and is based on precise preoperative planning. The purpose of this study was to determine the accuracy of glenoid component positioning when only the glenoid surface is visible, compared to when the entire scapula is visible on a 3D virtual model. Methods CT scans of 30 arthritic shoulders were reconstructed in 3D models. Two surgeons then virtually placed a glenosphere component in the model while visualizing only the glenoid surface, in order to simulate typical intraoperative exposure (“blind 3D” surgery). One surgeon then placed the component in an ideal position while visualizing the entire scapula (“visible 3D” surgery). These two positions were then compared, and the accuracy of glenoid component positioning was assessed in terms of correction of native glenoid version and tilt, and avoidance of glenoid vault perforation. Results Mean version and tilt after “blind 3D” surgery were +1.4° (SD 8.8°) and +7.6° (SD 6°), respectively; glenoid vault perforation occurred in 17 specimens. Mean version and tilt after “visible 3D” surgery were +0.3° (SD 0.8°) and +0.1° (SD 0.5°), respectively, with glenoid vault perforation in 6 cases. “Visible 3D” surgery provided significantly better accuracy than “blind 3D” surgery (P < 0.05). Conclusion When the entire scapula is used as reference, accuracy is improved and glenoid vault perforation is less frequent. This type of visualization is only possible with pre-operative 3D CT planning, and may be augmented by PSI. Level of evidence Basic science study. Level III.
AB - Background Glenoid component positioning in reverse shoulder arthroplasty (RSA) is challenging. Patient-specific instrumentation (PSI) has been advocated to improve accuracy, and is based on precise preoperative planning. The purpose of this study was to determine the accuracy of glenoid component positioning when only the glenoid surface is visible, compared to when the entire scapula is visible on a 3D virtual model. Methods CT scans of 30 arthritic shoulders were reconstructed in 3D models. Two surgeons then virtually placed a glenosphere component in the model while visualizing only the glenoid surface, in order to simulate typical intraoperative exposure (“blind 3D” surgery). One surgeon then placed the component in an ideal position while visualizing the entire scapula (“visible 3D” surgery). These two positions were then compared, and the accuracy of glenoid component positioning was assessed in terms of correction of native glenoid version and tilt, and avoidance of glenoid vault perforation. Results Mean version and tilt after “blind 3D” surgery were +1.4° (SD 8.8°) and +7.6° (SD 6°), respectively; glenoid vault perforation occurred in 17 specimens. Mean version and tilt after “visible 3D” surgery were +0.3° (SD 0.8°) and +0.1° (SD 0.5°), respectively, with glenoid vault perforation in 6 cases. “Visible 3D” surgery provided significantly better accuracy than “blind 3D” surgery (P < 0.05). Conclusion When the entire scapula is used as reference, accuracy is improved and glenoid vault perforation is less frequent. This type of visualization is only possible with pre-operative 3D CT planning, and may be augmented by PSI. Level of evidence Basic science study. Level III.
KW - Accuracy
KW - CT-assisted surgery
KW - Glenoid component positioning
KW - Patient-specific instrumentation
KW - Preoperative planning
KW - Reverse shoulder arthroplasty
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U2 - 10.1016/j.otsr.2016.12.019
DO - 10.1016/j.otsr.2016.12.019
M3 - Article
C2 - 28238965
AN - SCOPUS:85017152151
SN - 1877-0568
VL - 103
SP - 407
EP - 413
JO - Orthopaedics and Traumatology: Surgery and Research
JF - Orthopaedics and Traumatology: Surgery and Research
IS - 3
ER -