High intraoperative accuracy and low complication rate of computer-assisted navigation of the glenoid in total shoulder arthroplasty

Larose, Gabriel; Greene, Alexander T.; Jung, A.; Polakovic, Sandrine; Davis, Noah Z.; Zuckerman, Joseph D.; Virk, Mandeep S.

doi:10.1016/j.jse.2022.12.021

Cited by 10 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They reported an average error from the preoperative plan of 1.9 ± 1.9° for version and 2.4 ± 2.4° for inclination of glenoid component. Larose et al [ 29 ] compared preoperative planning and intraoperative navigated glenoid position in a large study population. They reported minimal deviation in the intraoperative execution of the preoperative plan with respect to version (0.6° ± 1.96°), inclination (0.2° ± 2.04°) and starting point on the glenoid face (1.90 mm ± 1.2 mm).…”

Section: Discussionmentioning

confidence: 99%

Navigation in reverse shoulder arthroplasty: how the lateralization of glenosphere can affect the clinical outcome

Tarallo

Giorgini

Micheloni

et al. 2023

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction One of the main causes of RSA failure is attributable to the malpositioning of the glenoid component. Initial experiences with computer-assisted surgery have shown promising results in increasing the accuracy and repeatability of placement of the glenoid component and screws. The aim of this study was to evaluate the functional clinical results, in terms of joint mobility and pain, by correlating them with intraoperative data regarding the positioning of the glenoid component. The hypothesis was that the lateralization more than 25 mm of the glenosphere can led to better stability of the prosthesis but should pay in term of a reduced range of movement and increased pain. Materials and methods 50 patients were enrolled between October 2018 and May 2022; they underwent RSA implantation assisted by GPS navigation system. Active ROM, ASES score and VAS pain scale were recorded before surgery. Preoperative data about glenoid inclination and version were collected by pre-op X-Rays an CT. Intraoperative data—inclination, version, medialization and lateralization of the glenoid component—were recorded using computer-assisted surgery. 46 patients had been further clinically and radiographically re-evaluated at 3-months, 6-months, 1-year, and 2-years follow-up. Results We found a statistically significant correlation between anteposition and glenosphere lateralization value (DM − 6.057 mm; p = 0.043). Furthermore a statistically significant correlation has been shown between abduction movement and the lateralization value (DM − 7.723 mm; p = 0.015). No other statistically significant associations were found when comparing the values of glenoid inclination and version with the range of motion achieved by the patients after reverse shoulder arthroplasty. Conclusion We observed that the patients with the best anteposition and abduction results had a glenosphere lateralization between 18 and 22 mm. When increasing the lateralization above 22 mm or reducing it below 18 mm, on the other hand, both movements considered decreased their range. Level of evidence Level IV; Case Series; Treatment Study.

show abstract

Section: Discussionmentioning

confidence: 99%

Navigation in reverse shoulder arthroplasty: how the lateralization of glenosphere can affect the clinical outcome

Tarallo

Giorgini

Micheloni

et al. 2023

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

“…al. reported their results on 16 723 TSA performed worldwide with the navigation system (30). In 98% of cases (16,368), the navigation procedure was completed without abandoning its use during surgery.…”

Section: Glenoid Component Positioningmentioning

confidence: 99%

“…Intraoperative navigation has gained widespread acceptance in orthopedic surgery, especially in hip and knee arthroplasty ( 28 ). Recently, it has been demonstrated that intraoperative navigation can enhance the precise positioning of components, thereby reducing the incidence of malpositioning by providing the ability to detect glenoid reaming depth, optimize baseplate screw trajectory, and offer real-time feedback during the procedure ( 29 , 30 ). Comparable advantages can be achieved concerning the precision of the glenoid positioning, stability of the baseplate, and humeral cut ( 31 ).…”

Section: Introductionmentioning

confidence: 99%

“…Minimal deviations were observed in the execution of the preoperative plan for version (0.6° ± 1.96°), inclination (0.2° ± 2.04°), and the starting point on the glenoid face (1.90 mm ± 1.2 mm). There were nine reported cases of coracoid fractures (0.05%) ( 30 ). The use of navigation resulted in over twice the incidence of augmented glenoid components (45.5% vs 19.2%), markedly decreasing variability in postoperative version ( 33 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

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.

show abstract

“…Similarly, studies have shown computer navigation leads to more accurate glenoid component placement and less deviation from the preoperative plan. 65,66 While these technologies have shown to be beneficial in aiding surgeons to recreate their preoperative plan more accurately, clinical studies showing improvement in patient outcomes when compared with conventional techniques are lacking. Nevertheless, these technologies are important tools in the planning and execution of shoulder arthroplasty, especially in cases of significant deformity where an augmented glenoid component and/or bone graft may be used (Table I).…”

Section: Impact Of Guidance Technology On Augment Use In Shoulder Art...mentioning

confidence: 99%

Treatment of Glenoid Wear with the Use of Augmented Glenoid Components in Total Shoulder Arthroplasty

Contreras,

Kingery,

Zuckerman

et al. 2023

JBJS Reviews

Self Cite

View full text Add to dashboard Cite

» Treatment of glenoid bone loss continues to be a challenge in total shoulder arthroplasty (TSA). Although correcting glenoid wear to patient's native anatomy is desirable in TSA, there is lack of consensus regarding how much glenoid wear correction is acceptable and necessary in both anatomic and reverse TSA.» Use of augmented glenoid components is a relatively new treatment strategy for addressing moderate-to-severe glenoid wear in TSA. Augmented glenoid components allow for predictable and easy correction of glenoid wear in the coronal and/or axial planes while at the same time maximizing implant seating, improving rotator cuff biomechanics, and preserving glenoid bone stock because of off-axis glenoid reaming.» Augmented glenoid components have distinct advantages over glenoid bone grafting. Glenoid bone grafting is technically demanding, adds to the surgical time, and carries a risk of nonunion and graft resorption with subsequent failure of the glenoid component.» The use of augmented glenoid components in TSA is steadily increasing with easy availability of computed tomography–based preoperative planning software and guidance technology (patient-specific instrumentation and computer navigation).» Although different augment designs (full wedge, half wedge, and step cut) are available and a particular design may provide advantages in specific glenoid wear patterns to minimize bone removal (i.e. a half wedge in B2 glenoids), there is no evidence to demonstrate the superiority of 1 design over others.

show abstract

High intraoperative accuracy and low complication rate of computer-assisted navigation of the glenoid in total shoulder arthroplasty

Cited by 10 publications

References 14 publications

Navigation in reverse shoulder arthroplasty: how the lateralization of glenosphere can affect the clinical outcome

Navigation in reverse shoulder arthroplasty: how the lateralization of glenosphere can affect the clinical outcome

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

Treatment of Glenoid Wear with the Use of Augmented Glenoid Components in Total Shoulder Arthroplasty

Contact Info

Product

Resources

About