Anatomic total shoulder glenoid component inclination affects glenohumeral kinetics during abduction: a cadaveric study

Knighton, Tyler W.; Chalmers, Peter N.; Sulkar, Hema J.; Aliaj, Klevis; Tashjian, Robert Z.; Henninger, Heath B.

doi:10.1016/j.jse.2022.03.028

Cited by 13 publications

(3 citation statements)

References 41 publications

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“…In addition, consistent biomechanical data support that superior glenosphere inclination is associated with an increase in component impingement during shoulder adduction and greater shear forces, potentially negatively affecting baseplate fixation and implant survival 44,50,51 . In general, the superior inclination of the glenoid component should be avoided in rTSA because of the increased risk of loosening, scapular notching, restricted motion, and instability, especially noted in nonlateralized glenoid components [52][53][54][55] .…”

Section: Discussionmentioning

confidence: 85%

The Value of Computer-Assisted Navigation for Glenoid Baseplate Implantation in Reverse Shoulder Arthroplasty

Velasquez Garcia,

Abdo,

Sanchez-Sotelo

et al. 2023

JBJS Reviews

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Background: Glenoid baseplate malpositioning during reverse total shoulder arthroplasty can contribute to perimeter impingement, dislocation, and loosening. Despite advances in preoperative planning, conventional instrumentation may lead to considerable inaccuracy in implant positioning unless patient-specific guides are used. Optical navigation has the potential to improve accuracy and precision when implanting a reverse shoulder arthroplasty baseplate. This systematic review aimed to analyze the most recent evidence on the accuracy and precision of glenoid baseplate positioning using intraoperative navigation and its potential impact on component selection and surgical time. Methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The PubMed, Scopus, and EMBASE databases were queried in July 2022 to identify all studies that compared navigation vs. conventional instrumentation for reverse shoulder arthroplasty. Data of deviation from the planned baseplate version and inclination, the use of standard or augmented glenoid components, and surgical time were extracted. Quantitative analysis from the included publications was performed using the inverse-variance approach and Mantel-Haenszel method. Results: Of the 2,048 records identified in the initial query, only 10 articles met the inclusion and exclusion criteria, comprising 667 shoulders that underwent reverse total shoulder arthroplasty. The pooled mean difference (MD) of the deviation from the planned baseplate position for the clinical studies was −0.44 (95% confidence interval [CI], −3.26; p = 0.76; I2 = 36%) for version and −8.75 (95% CI, −16.83 to −0.68; p = 0.02; I2 = 83%) for inclination, both in favor of navigation. The odds ratio of selecting an augmented glenoid component after preoperative planning and navigation-assisted surgery was 8.09 (95% CI, 3.82-17.14; p < 0.00001; I2 = 60%). The average surgical time was 12 minutes longer in the navigation group (MD 12.46, 95% CI, 5.20-19.72; p = 0.0008; I2 = 71%). Conclusions: Preoperative planning integrated with computer-assisted navigation surgery seems to increase the accuracy and precision of glenoid baseplate inclination compared with the preoperatively planned placement during reverse total shoulder arthroplasty. The surgical time and proportion of augmented glenoid components significantly increase when using navigation. However, the clinical impact of these findings on improving prosthesis longevity, complications, and patient functional outcomes is still unknown. Level of Evidence: Level III, systematic review and meta-analysis. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 85%

The Value of Computer-Assisted Navigation for Glenoid Baseplate Implantation in Reverse Shoulder Arthroplasty

Velasquez Garcia,

Abdo,

Sanchez-Sotelo

et al. 2023

JBJS Reviews

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“…Similarly, placement of a superiorly inclined glenoid component during TSA can result in superior humeral translation, which can cause loosening and cuff strain through the rocking horse phenomenon, irrespective of preoperative inclination status 23 . In a cadaveric study, Knighton et al 26 examined muscle and joint contact forces in inferiorly and superiorly inclined glenoid components. They found that inferior inclination reduced overall muscle forces with motion, whereas superior inclination led to increased muscle use and chronic muscle stress in the post-TSA rotator cuff.…”

Section: Risk Factorsmentioning

confidence: 99%

Secondary Rotator Cuff Insufficiency After Anatomic Total Shoulder Arthroplasty

Ardebol,

Pak,

Kiliç

et al. 2023

JBJS Reviews

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» Secondary rotator cuff insufficiency is a challenging complication after anatomic total shoulder arthroplasty.» Acute tears may be amenable to open or arthroscopic repair in some instances.» Chronic attritional tears are best managed with revision to reverse shoulder arthroplasty, especially in the elderly.» Increased glenoid inclination, larger critical shoulder angle, oversized humeral components, thicker glenoid components, and rotator cuff muscle fatty infiltration have all shown to contribute to tear risk.

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“… 15 , 16 This is of particular importance with respect to the glenoid component because glenoid loosening has been shown to be the leading cause of failure after anatomic TSA and is commonly a result of malpositioning, bone loss, and altered joint reactive forces. 17 , 18 , 19 Several commercial preoperative planning software resources are available to determine the optimal size and positioning of prosthetic components yet do so at significant cost and with meaningful time constraints. At our institution, we have applied the principles of these technologies to develop a custom, 3D printed glenoid guide for accurate placement of the central pin.…”

mentioning

confidence: 99%

Custom, 3-Dimensional Patient-Specific Instrumentation in Anatomic Total Shoulder Arthroplasty: Part 1—Preoperative Assessment, Preoperative Planning, and Guide Design

Kerzner,

Khan,

Dasari

et al. 2023

Arthroscopy Techniques

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Anatomic total shoulder glenoid component inclination affects glenohumeral kinetics during abduction: a cadaveric study

Cited by 13 publications

References 41 publications

The Value of Computer-Assisted Navigation for Glenoid Baseplate Implantation in Reverse Shoulder Arthroplasty

The Value of Computer-Assisted Navigation for Glenoid Baseplate Implantation in Reverse Shoulder Arthroplasty

Secondary Rotator Cuff Insufficiency After Anatomic Total Shoulder Arthroplasty

Custom, 3-Dimensional Patient-Specific Instrumentation in Anatomic Total Shoulder Arthroplasty: Part 1—Preoperative Assessment, Preoperative Planning, and Guide Design

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