“…Furthermore, the application of computer navigation in this setting may result in better prosthetic longevity and decreased need for revision procedures [ 7 , 22 ]. Recent studies have shown that navigation can improve the accuracy of placement of the inferior tilt of the glenoid component [ 19 , 36 ], which was not possible in the past [ 20 ].…”
Section: Reviewmentioning
confidence: 99%
“…This combined with limited glenoid exposure makes it difficult to place glenoid components accurately. Subsequent malalignment results in an unbalanced kinematic environment, eccentric loading, disordered vector forces, and an increase in the contact pressure and edge loading, hindering the ultimate success of the shoulder arthroplasty procedure [5,6,[18][19][20][21].…”
Total shoulder arthroplasty (TSA) has been demonstrated to successfully recover function to shoulders impaired by arthrosis and rotator cuff insufficiency. Long-term survival depends on the correct positioning of glenoid components and secure bone fixation. Computed tomography (CT)-based intraoperative navigation has proven to be an effective technique for successful TSA procedures. This paper presents a review of CT-based intraoperative navigation considering its advantages and disadvantages. The crucial factors that contribute to the success of this technique are glenoid component positioning, operative duration, and screw selection, which are detailed in this review.
“…Furthermore, the application of computer navigation in this setting may result in better prosthetic longevity and decreased need for revision procedures [ 7 , 22 ]. Recent studies have shown that navigation can improve the accuracy of placement of the inferior tilt of the glenoid component [ 19 , 36 ], which was not possible in the past [ 20 ].…”
Section: Reviewmentioning
confidence: 99%
“…This combined with limited glenoid exposure makes it difficult to place glenoid components accurately. Subsequent malalignment results in an unbalanced kinematic environment, eccentric loading, disordered vector forces, and an increase in the contact pressure and edge loading, hindering the ultimate success of the shoulder arthroplasty procedure [5,6,[18][19][20][21].…”
Total shoulder arthroplasty (TSA) has been demonstrated to successfully recover function to shoulders impaired by arthrosis and rotator cuff insufficiency. Long-term survival depends on the correct positioning of glenoid components and secure bone fixation. Computed tomography (CT)-based intraoperative navigation has proven to be an effective technique for successful TSA procedures. This paper presents a review of CT-based intraoperative navigation considering its advantages and disadvantages. The crucial factors that contribute to the success of this technique are glenoid component positioning, operative duration, and screw selection, which are detailed in this review.
“…O-arm navigation utilization in RTSA was studied by Sasaki et al 36 in a case-control study. No significant difference was found between the range of error for version in the control and navigated groups, but a significant improvement was observed in the range of error for inclination in the navigated group.…”
Section: Glenoid Bone Lossmentioning
confidence: 99%
“…Navigation has shown promise in allowing surgeons to precisely target glenoid fixation. [35][36][37] This may be particularly helpful in cases with poor glenoid bone stock in which there is less room for error in fixating the glenosphere in a precise location. O-arm navigation utilization in RTSA was studied by Sasaki et al 36 in a case-control study.…”
Bone loss of either the glenoid or the humerus is a challenging problem in reverse total shoulder arthroplasty. When left unaddressed, it can lead to early failure of the implant and poor outcomes. Humeral bone loss can be addressed with the use of an endoprosthesis or allograft prosthetic implant. Glenoid bone loss can be treated with a variety of grafting options, such as augmented implants, patient-specific navigation, and implantation systems.
“…4 The incidence of these complications can be diminished by placing the baseplate in the ''ideal position'' previously described by other authors. 5,6 Different surgical assistance systems have been developed such as navigated or computer-assisted surgery (CAS) or patient-specific instruments (PSI) based on presurgical CT scan. Several studies have shown that they provide greater accuracy in the implantation of the GC compared to the use of conventional instrumentation.…”
Background Accurate placement of glenoid component in reverse shoulder arthroplasty remains a challenge for surgeons of all levels of expertise; however, no studies have evaluated the utility of fluoroscopy as a surgical assistance method. Methods Prospective comparative study of 33 patients undergoing primary reverse shoulder arthroplasty during a 12-month period. Fifteen patients had a baseplate placed using the conventional “free hand” technique (control group), and 18 patients using intraoperative fluoroscopy assistance group, in a case–control design. Postoperative glenoid position was evaluated on postoperative Computed Tomography (CT) scan. Results The mean deviation of version and inclination for fluoroscopy assistance vs. control group was 1.75° (0.675–3.125) vs. 4.2° (1.975–10.45) (p = .015), and 3.85° (0–7.225) vs. 10.35° (4.35–18.75) (p = .009). The distance from the central peg midpoint to the inferior glenoid rim (fluoroscopy assistance 14.61 mm/control 4.75 mm, p = .581) and the surgical time (fluoroscopy assistance 1.93 ± 0.57/control 2.18 ± 0.44 h, p = .400) showed no differences, with an average radiation dose of 0.45 mGy and fluoroscopy time of 14 s. Conclusions Accurate axial and coronal scapular plane positioning of glenoid component is improved with intraoperative fluoroscopy at the cost of a greater radiation dose and without differences in surgical time. Comparative studies are needed to determine whether their use in relation to more expensive surgical assistance systems result in similar effectiveness. Level of evidence: Level III, therapeutic study.
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