Effect of glenoid deformity on glenoid component placement in primary shoulder arthroplasty

The Use of Patient-Specific Instrumentation Improves the Accuracy of Acetabular Component Placement

“…In addition to virtual factors, to place the PSI and the guidewires in vivo, the surgeon will need to fully expose the joint's bony surface by removing all soft tissue and loose bodies to closely match the virtual images used to generate the PSIs. These joint exposure issues have been considered and tested in a prior clinical study using this same technology without the use of the PSIs [32]. In that study, we validated that ArthroPlan technology accurately defined the glenoid surfaces found at the time of surgery in 13 consecutive patients undergoing primary joint arthroplasty.…”

“…Even in the hands of the most experienced arthroplasty surgeons, the use of standard preoperative planning using x-rays and CT scan with generic instrumentation provided by the implant manufacturer results in inconsistent placement of components, particularly in cases of significant joint deformity [32]. With limited joint exposure, the relationship of the acetabular fossa to the plane of the pelvis in 3 dimensions can be accomplished reliably only using intraoperative computer-assisted navigation.…”

Accuracy of the glenohumeral subluxation index in nonpathologic shoulders

“…1,11,13,15,25,26,32 These have been shown to reflect the true anatomy more accurately, leading to more accurate component placement in TSA. 13,15 We showed that the 3D HSI is more reliable and accurate than the current 2D HSI. Although it is a more time-consuming method and it implies the need for a 3D reconstruction software program, a 3D subluxation index seems to be a useful preoperative measurement tool leading to improvement of the clinical outcome of TSA.…”

Surgical management of the biconcave (B2) glenoid

“…Standard total shoulder arthroplasty (TSA) may offer excellent functional results but requires careful correction of pathologic bone deformity, restoration of the native joint line, and proper soft tissue balancing to ensure glenoid implant stability. Glenoid component malposition, particularly component retroversion, is a significant risk factor for early lucent lines and failure [7][8][9]. Increasing glenoid retroversion has been associated with increased risk of component malposition particularly when standard components are used [8,10].…”

“…The humeral glenoid alignment (HGA) is measured from the center of rotation of the humeral head to a line placed at the center of the glenoid that is perpendicular to the glenoid plane inclination. Additionally, this information can help the surgeon select the optimal implant to restore native glenoid anatomy, while avoiding peg perforation [7,26,27]. Patient specific instrumentation has been developed to help transfer information from the preoperative planning software to the patient [25].…”