A novel method for localization of the maximum glenoid bone defect during reverse shoulder arthroplasty

Harding, Graeme T.; Bois, Aaron J.; Bouliane, Martin

doi:10.1016/j.jseint.2021.04.001

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…The presently investigated 3D classification is quantifiable with precise cut-off values and may therefore be better suited to such an automated computer-based software algorithm. Being 3D, it is more aligned with current developments in imaging software, preoperative planning and instrumentation than previous two-dimensional classification systems [23][24][25]. Modern 3D planning software already comprise algorithms which calculate the anteroposterior subluxation and these merely need to be modified to include superoinferior alignment [24,26].…”

Section: Discussionmentioning

confidence: 99%

Validation of a novel 3-dimensional classification for degenerative arthritis of the shoulder

Kleim,

Lappen,

Kadantsev

et al. 2023

Arch Orthop Trauma Surg

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Introduction A novel three-dimensional classification to comprehensively describe degenerative arthritis of the shoulder (DAS) was recently published by our group. The purpose of the present work was to investigate intra- and interobserver agreement as well as validity for the three-dimensional classification. Materials and methods Preoperative computed tomography (CT) scans of 100 patients who had undergone shoulder arthroplasty for DAS were randomly selected. Four observers independently classified the CT scans twice, with an interval of 4 weeks, after prior three-dimensional reconstruction of the scapula plane using a clinical image viewing software. Shoulders were classified according to biplanar humeroscapular alignment as posterior, centered or anterior (> 20% posterior, centered, > 5% anterior subluxation of humeral head radius) and superior, centered or inferior (> 5% inferior, centered, > 20% superior subluxation of humeral head radius). Glenoid erosion was graded 1–3. Gold-standard values based on precise measurements from the primary study were used for validity calculations. Observers timed themselves during classification. Cohen’s weighted κ was employed for agreement analysis. Results Intraobserver agreement was substantial (κ = 0.71). Interobserver agreement was moderate with a mean κ of 0.46. When the additional descriptors extra-posterior and extra-superior were included, agreement did not change substantially (κ = 0.44). When agreement for biplanar alignment alone was analyzed, κ was 0.55. The validity analysis reached moderate agreement (κ = 0.48). Observers took on average 2 min and 47 s (range 45 s to 4 min and 1 s) per CT for classification. Conclusions The three-dimensional classification for DAS is valid. Despite being more comprehensive, the classification shows intra- and interobserver agreement comparable to previously established classifications for DAS. Being quantifiable, this has potential for improvement with automated algorithm-based software analysis in the future. The classification can be applied in under 5 min and thus can be used in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Validation of a novel 3-dimensional classification for degenerative arthritis of the shoulder

Kleim,

Lappen,

Kadantsev

et al. 2023

Arch Orthop Trauma Surg

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“…This permits the surgeon to preoperatively assess the location, orientation and amount of high-side reaming and can be used as an intraoperative reference during glenoid preparation. 8 Once the baseplate has been positioned appropriately the “patient-specific bone graft” option is selected and is then evaluated for its shape, angulation, and orientation. The location of the maximum (or deepest) aspect of the bony defect is noted on the plan, which corresponds to the deepest part of the patient-specific graft.…”

Section: Surgical Techniquementioning

confidence: 99%

“…9 The glenoid surface is then thoroughly assessed and the “point of maximal glenoid defect” is marked with electrocautery, which will be located approximately 90° from the line formed by the eccentric ream. 8 The graft is then placed over the central post of the glenoid baseplate and oriented to ensure that the thickest portion of the graft will be inserted at the marked “point of maximal glenoid defect.” A long hydroxyapatite (HA)-coated central post is preferred over a central screw in such cases to ensure at least 1 cm of the post gains sufficient purchase into the patient's native glenoid bone at the time of implant insertion. Furthermore, an HA-coated post theoretically permits bony ongrowth over time from both the native glenoid and the bone graft versus a central screw that obtains variable bone purchase into the native glenoid and no bony ongrowth.…”

Section: Surgical Techniquementioning

confidence: 99%

The Use of an External Cutting Guide for Patient-Specific Bone Grafting in Reverse Total Shoulder Arthroplasty: A Novel Technique

Harding,

Bois,

Cavanagh

et al. 2023

Journal of Shoulder and Elbow Arthroplasty

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Glenoid bone loss remains a substantial challenge in reverse shoulder arthroplasty and failure to address such bone loss may lead to implant malpositioning, instability and/or premature baseplate loosening. Currently, management of glenoid bone loss can be achieved by metal augmentation or bone grafting (ie, autograft or allograft). At the present time, options for creating and shaping glenoid bone grafts include free-hand techniques and simple reusable cutting guides that create the graft at a standard shape/angle. To our knowledge, there is no external guide available that enables surgeons to accurately prepare the bone graft to the desired dimensions/shape (ie, trapezoid or biplanar) to correct the glenoid deformity. In this article, we present a novel surgical technique that utilizes an external guide for creating a patient-specific bone graft to address glenoid deformity in the setting of reverse total shoulder arthroplasty.

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3D Printed Patient-Specific Cutting Guides for Bone Grafting in Reverse Shoulder Arthroplasty: A Novel Technique

Karpyshyn

Bois

Logan

et al. 2023

Journal of Shoulder and Elbow Arthroplasty

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Glenoid bone loss remains a challenge in shoulder arthroplasty. Addressing substantial bone loss is essential to ensure proper function and stability of the shoulder prosthesis and to prevent baseplate loosening and subsequent revision surgery. Current options for creating and shaping glenoid bone grafts include free-hand techniques and simple reusable cutting guides that cut the graft at a standard angle. There is currently no patient-specific device available that enables surgeons to accurately prepare the bone graft and correct glenoid deformity. We present a novel surgical technique using three-dimensional (3D)-printed cutting guides to create a patient-specific bone graft to address glenoid deformity in the setting of reverse shoulder arthroplasty.

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A novel method for localization of the maximum glenoid bone defect during reverse shoulder arthroplasty

Cited by 3 publications

References 24 publications

Validation of a novel 3-dimensional classification for degenerative arthritis of the shoulder

Validation of a novel 3-dimensional classification for degenerative arthritis of the shoulder

The Use of an External Cutting Guide for Patient-Specific Bone Grafting in Reverse Total Shoulder Arthroplasty: A Novel Technique

3D Printed Patient-Specific Cutting Guides for Bone Grafting in Reverse Shoulder Arthroplasty: A Novel Technique

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