Intraoperative navigation and preoperative templating software are associated with increased glenoid baseplate screw length and use of augmented baseplates in reverse total shoulder arthroplasty

Abstract

Background Preoperative templating software and intraoperative navigation have the potential to impact baseplate augmentation utilization and increase screw length for baseplate fixation in reverse total shoulder arthroplasty (rTSA). We aimed to assess their impact on the (1) baseplate screw length, (2) number of screws used, and (3) frequency of augmented baseplate use in navigated rTSA. Methods We compared 51 patients who underwent navigated rTSA with 63 controls who underwent conventional rTSA at a single institution. Primary outcomes included the screw length, composite screw length, number of screws used, percentage of patients in whom 2 screws in total were used, and use of augmented baseplates. Results Navigation resulted in the use of significantly longer individual screws (36.7 mm vs. 30 mm, P < .0001), greater composite screw length (84 mm vs. 76 mm, P = .048), and fewer screws (2.5 ± 0.7 vs. 2.8 ± 1, P = .047), as well as an increased frequency of using 2 screws in total (35 of 51 patients [68.6%] vs. 32 of 63 controls [50.8%], P = .047). Preoperative templating resulted in more frequent augmented baseplate utilization (76.5% vs. 19.1%, P < .0001). Conclusion The difference in the screw length, number of screws used, and augmented baseplate use demonstrates the evolving role that computer navigation and preoperative templating play in surgical planning and the intraoperative technique for rTSA.

Two-year clinical outcomes of total shoulder arthroplasty performed with a computer navigated surgery system

“…Other findings include an increased number of augmented glenoid implants in both ATSA and RTSA navigated cohorts and a decreased number of baseplate screws in the RTSA navigated cohort when intraoperative navigation was used, which has also been observed in other studies 4,5 .…”

Glenoid Component Placement Assisted by Augmented Reality Through a Head-Mounted Display During Reverse Shoulder Arthroplasty

“… 11 Sprowls et al. 19 evaluated a computational navigation system combined with patients’ preoperatory images in real time. The authors confirmed that a better placement of baseplate screws was achieved.…”

Clinico-radiological correlation of reverse shoulder arthroplasty outcomes

“…However, this requires learning time. 24 The major limitation of our study was limited number of enrolled patients. A larger sample size would have been able to test for more precise interactions between independent variables.…”