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Computer navigation re-creates planned glenoid placement and reduces correction variability in total shoulder arthroplasty: an in vivo case-control study.

Abstract：

BACKGROUND:Accurate glenoid component placement is important to prevent glenoid component failure in total shoulder arthroplasty (TSA). Navigation may reduce the variability of glenoid component version and inclination; therefore, the aims of this study were to determine, in patients undergoing TSA, whether computer navigation improved the ability to achieve neutral postoperative version and inclination, as well as achieve the individualized preoperative plan. METHODS:Patients undergoing TSA using navigation (computer-assisted surgery [CAS], n = 33) or the conventional technique (n = 27) from January 2014 to July 2017 were recruited and compared. Preoperative and postoperative version and inclination, as well as postoperative inferior overhang, were measured using computed tomography scans. RESULTS:The CAS group had more than twice as many augmented glenoid components as the conventional group (45.5% vs. 19.2%). CAS significantly reduced the between-patient variability in postoperative version and led to a greater proportion of components positioned in "neutral" alignment for both inclination and version (P < .015). The incidence of neutral inclination or version postoperatively was significantly higher in the CAS group, and the glenoid was implanted within 5° of the surgical plan in more than 70% of cases, with more than 40% displaying no detectable difference. CONCLUSION:An integrated system of 3-dimensional surgical planning, augmented glenoid components, and intraoperative navigation may reduce the risk of glenoid placement outside of a neutral position in patients undergoing TSA compared with conventional methods. This study demonstrated the capacity for CAS to replicate the surgical plan in a majority of cases.

journal_name

J Shoulder Elbow Surg

journal_title

Journal of shoulder and elbow surgery

authors

Nashikkar PS,Scholes CJ,Haber MD

doi

10.1016/j.jse.2019.04.037

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

e398-e409

issue

eissn

1058-2746

issn

1532-6500

pii

S1058-2746(19)30287-3

journal_volume

pub_type

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Computer navigation re-creates planned glenoid placement and reduces correction variability in total shoulder arthroplasty: an in vivo case-control study.