A Systematic Review of the Utility of Intraoperative Navigation During Total Shoulder Arthroplasty

Eng, Khemerin; Eyre-Brook, Alistair; Shields, David

doi:10.7759/cureus.33087

Cited by 4 publications

(12 citation statements)

References 37 publications

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“…Eng et al did a systematic review of GPS-navigated TSA vs. conventional TSA [ 7 ]. We did not do a comparison study as our patients who underwent GPS-navigated RSA were more complex cases and hence not comparable to the non-GPS cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Guided personalized surgery (GPS)-navigated RSA helps achieve better glenoid base plate positioning and fixation in these conditions [ 7 , 8 ]. The process involves a three-dimensional (3D) CT of the shoulder and a preoperative planning application to create GPS navigation based on the CT images.…”

Section: Introductionmentioning

confidence: 99%

“…There is evidence in the literature that suggests GPS-navigated RSA helps achieve good position of the glenoid base plate and secure peg and screw fixation [ 7 , 8 ]. We did a retrospective case series study to analyse the demographic data, implants, and functional results of GPS-navigated RSA at our institution.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Guided Personalized Surgery (GPS)-Navigated Reverse Polarity Total Shoulder Joint Replacement in a Low-Volume Hospital

Karuna Pathirannehelage,

Jayaram,

Bamunuarachchi

et al. 2023

Cureus

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Introduction Reverse polarity shoulder arthroplasty (RSA) is an evolving surgery, and its indications have expanded over time. Apart from cuff tear arthropathy (CTA), it is recommended for complex proximal humerus fractures in the elderly, inflammatory arthritis, primary osteoarthritis in the elderly, and revision for failed hemiarthroplasty. Glenoid base plate placement and fixation are important to prevent complications, especially glenoid base plate loosening, dislocation, and scapular notching, and to improve longevity. Guided personalized surgery (GPS)-navigated RSA was devised to optimize the glenoid base plate position and fixation. Methodology A retrospective study was carried out in a low-volume district general hospital in England. All the patients who underwent GPS-navigated RSA were included. Their preoperative glenoid version, bone stock, glenoid base plate, and glenoid screw lengths were analysed. Preoperative and post-surgery patient-reported outcomes were gathered using the Oxford Shoulder Score (OSS) at six months and annually thereafter. Results Fourteen patients have undergone GPS-navigated RSA in our institute since 2018. Ten patients were female. All of them had a retroverted glenoid with a mean value of 13.6 degrees. Ten out of 14 patients had an augmented glenoid base plate. This included six eight-degree posterior augmentations, three 10-degree superior augmentations, and one extended cage peg. The follow-up period was six months to five years, depending on the date of surgery, and none of the patients dropped out of follow-up. The OSS revealed statistically significant improvement from preoperative values to six months postoperative, an improvement of 21.64±7.175. It also showed progressive improvement over time during postoperative follow-up, and the three-year mean was 47. The commonest complication was fractures, which happened in four cases. There were no infections or dislocations. Discussion Guided personalized surgery-navigated RSA was performed on selected patients at our institution when they were not suitable for conventional RSA due to distorted glenoid anatomy. Glenoid base plate positioning and fixation are important to optimize the outcome of RSA. Guided personalized surgery navigation is helpful in achieving optimum glenoid base placement, especially when the normal glenoid anatomy is distorted. There were no dislocations, glenoid base plate loosening, or scapular notching in the study group. There were four reported fractures, which was comparable with the published literature.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of Guided Personalized Surgery (GPS)-Navigated Reverse Polarity Total Shoulder Joint Replacement in a Low-Volume Hospital

Karuna Pathirannehelage,

Jayaram,

Bamunuarachchi

et al. 2023

Cureus

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“… 3 , 7 Fortunately, in recent years 3-dimensional (3D) virtual planning based on computer tomography (CT) scan, intra-operative navigation, and patient-specific instrumentation (PSI) have been developed and employed as additional tools to improve accuracy in planning and execution of arthroplasties, both anatomic and RSA. 8 – 13 Specifically, a more precise glenoid and screw positioning, as well as bone stock preservation have been demonstrated. 13 This technology may be also useful for the management of complex cases of revision surgery where a customized component is needed, and the residual bone stock should be spared.…”

Section: Introductionmentioning

confidence: 99%

“… 8 – 13 Specifically, a more precise glenoid and screw positioning, as well as bone stock preservation have been demonstrated. 13 This technology may be also useful for the management of complex cases of revision surgery where a customized component is needed, and the residual bone stock should be spared.…”

Section: Introductionmentioning

confidence: 99%

Custom-made Glenoid Baseplate and Intra-Operative Navigation in Complex Revision Reverse Shoulder Arthroplasty: A Case Report

Peri,

Troiano,

Colasanti

et al. 2024

Journal of Shoulder and Elbow Arthroplasty

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Prosthetic instability is one of the most challenging complications to manage when considering reverse shoulder arthroplasty (RSA). Additional tools are available to improve accuracy in planning and execution of arthroplasties, such as 3-dimensional (3D) virtual planning based on computer tomography (CT) scan and intra-operative navigation. We report a case of an 84-year-old male treated for RSA prosthetic instability combined with severe glenoid deformity and bone loss, and subclinical periprosthetic joint infection (PJI). The definitive surgery consisted in implanting a customized metaglene component realized on the basis of the bone defect detected in the 3D-CT scan and implanted with the aid of computer-assisted intra-operative navigation. The patient was periodically followed-up for a year with clinical and radiological evaluations with the absence of further prosthetic dislocations nor PJI, a good overall satisfaction, a satisfying range of motion, and acceptable functional scores (American Shoulder and Elbow Surgeons Score 62, Constant-Murley Score 36). This is the first description, to our knowledge, of a customized glenoid baseplate implanted with the aid of intraoperative navigation. The combined use of 3D-CT planning and intra-operative computer-assisted navigation allows to manage complex cases of prosthetic revision surgery even where extensive bone defects are present.

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Three-dimensional planning, navigation, patient-specific instrumentation and mixed reality in shoulder arthroplasty: a digital orthopedic renaissance

Can Kolac,

Paksoy,

Akgün

2024

EFORT Open Reviews

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Accurate component placement in shoulder arthroplasty is crucial for avoiding complications, achieving superior biomechanical performance and optimizing functional outcomes. Shoulder and elbow surgeons have explored various methods to improve surgical understanding and precise execution including preoperative planning with 3D computed tomography (CT), patient-specific instrumentation (PSI), intraoperative navigation, and mixed reality (MR). 3D preoperative planning facilitated by CT scans and advanced software, enhances surgical precision, influences decision-making for implant types and approaches, reduces errors in guide pin placement, and contributes to cost-effectiveness. Navigation demonstrates benefits in reducing malpositioning, optimizing baseplate stability, improving humeral cut, and potentially conserving bone stock, although challenges such as varied operating times and costs warrant further investigation. The personalized patient care and enhanced operational efficiency associated with PSI are not only attractive for achieving desired component positions but also hold promise for improved outcomes in complex cases involving glenoid bone loss. Augmented reality (AR) and virtual reality (VR) technologies play a pivotal role in reshaping shoulder arthroplasty. They offer benefits in preoperative planning, intraoperative guidance, and interactive surgery. Studies demonstrate their effectiveness in AR-guided guidewire placement, providing real-time surgical advice during reverse total shoulder arthroplasty (RTSA). Additionally, these technologies show promise in orthopedic training, delivering superior realism and accelerating learning compared to conventional methods.

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A Systematic Review of the Utility of Intraoperative Navigation During Total Shoulder Arthroplasty

Cited by 4 publications

References 37 publications

Outcomes of Guided Personalized Surgery (GPS)-Navigated Reverse Polarity Total Shoulder Joint Replacement in a Low-Volume Hospital

Outcomes of Guided Personalized Surgery (GPS)-Navigated Reverse Polarity Total Shoulder Joint Replacement in a Low-Volume Hospital

Custom-made Glenoid Baseplate and Intra-Operative Navigation in Complex Revision Reverse Shoulder Arthroplasty: A Case Report

Three-dimensional planning, navigation, patient-specific instrumentation and mixed reality in shoulder arthroplasty: a digital orthopedic renaissance

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