Benefit of intraoperative navigation on glenoid component positioning during total shoulder arthroplasty

Sadoghi, Patrick; Vavken, Julia; Leithner, Andreas; Vavken, Patrick

doi:10.1007/s00402-014-2126-1

Cited by 47 publications

(34 citation statements)

References 29 publications

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“…A comprehensive review of the literature confirmed its superior accuracy to the conventional method regarding the positioning of the glenoid component. 14 The navigation has benefits for both ATSA 1,10,16 and RTSA, 12,15,16,21 especially when the anatomy is distorted by fractures, revisions, wear, or dysplasia of the glenoid. 9,10 The contraindications to navigation are the same for shoulder arthroplasties, such as active or latent infection and generally poor health.…”

Section: Discussionmentioning

confidence: 99%

Navegação em cirurgia de artroplastia de ombro

Nascimento

Ikemoto

Wright

2020

Rev Bras Ortop (Sao Paulo)

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ResumoA indicação de artroplastias do ombro aumentou progressivamente. O posicionamento preciso dos componentes pode ter implicações significativas para os resultados clínicos. A navegação utilizada para auxiliar no desempenho de artroplastias totais anatômicas e reversas tem proporcionado maior precisão na colocação do implante, especialmente do componente glenoidal. O desenvolvimento da técnica, do material e do desenho da prótese têm mostrado resultados encorajadores e levado a uma tendência de expansão da sua utilização. Dessa forma, estimamos uma maior sobrevida das artroplastias resultantes de menores taxas de instabilidade e soltura precoce. Nosso objetivo é descrever a técnica atual e apresentar os resultados da literatura com navegação. No entanto, estudos clínicos comparativos com acompanhamento de longo prazo são necessários para comprovar a eficácia nos resultados finais das artroplastias totais do ombro.

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Section: Discussionmentioning

confidence: 99%

Navegação em cirurgia de artroplastia de ombro

Nascimento

Ikemoto

Wright

2020

Rev Bras Ortop (Sao Paulo)

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“…Additionally, the need for clear en-face access to the joint surfaces requires humeral dislocation, which has been linked to intraoperative nerve injury [12][13][14]. Furthermore, traditional surgical techniques have been shown to be prone to outliers in implantation accuracy that are associated with poor TSA outcomes [15][16][17][18][19][20]. These complications are particularly problematic in younger patients who have greater functional expectations and who necessitate longer implant survival [21,22].…”

Section: Introductionmentioning

confidence: 99%

Development and ex-vivo assessment of a novel patient specific guide and instrumentation system for minimally invasive total shoulder arthroplasty

et al. 2021

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Objective To develop and assess a novel guidance technique and instrumentation system for minimally invasive short-stemmed total shoulder arthroplasty that will help to reduce the complications associated with traditional open replacement such as poor muscle healing and neurovascular injury. We have answered key questions about the developed system including (1) can novel patient-specific guides be accurately registered and used within a minimally invasive environment?; (2) can accuracy similar to traditional techniques be achieved? Methods A novel intra-articular patient-specific guide was developed for use with a new minimally invasive posterior surgical approach that guides bone preparation without requiring muscle resection or joint dislocation. Additionally, a novel set of instruments were developed to enable bone preparation within the minimally invasive environment. The full procedure was evaluated in six cadaveric shoulders, using digitizations to assess accuracy of each step. Results Patient-specific guide registration accuracy in 3D translation was 2.2±1.2mm (RMSE±1 SD; p = 0.007) for the humeral component and 2.7±0.7mm (p<0.001) for the scapula component. Final implantation accuracy was 2.9±3.0mm (p = 0.066) in translation and 5.7–6.8±2.2–4.0° (0.001<p<0.009) across the humerus implants’ three rotations. Similarly, the glenoid component’s implantation accuracy was 3.0±1.7mm (p = 0.008) in translation and 2.3–4.3±2.2–4.4° (0.008<p<0.09) in rotation. Conclusion This system achieves minimally invasive shoulder replacement with accuracy similar to traditional open techniques while avoiding common causes of complications. Significance This novel technique could lead to a paradigm shift in shoulder arthroplasty for patients with moderate arthritis, which could significantly improve rehabilitation and functional outcomes.

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“…In contrast, intraoperative real- time 3D image intensifier based reconstructions combined with navigation is known to ensure accurate implant positioning and reducing complications using intraoperatively acquired images [16, 17]. Thus, navigated implantation of shoulder arthroplasty has an increasing role [4, 11, 18, 19] and might improve positioning of the glenoid component [4, 18, 20, 21]. Although a few cadaver studies suggest a benefit of intraoperative 3D imaging combined with navigation in rTSA [22, 23], clinical studies are still rare.…”

Section: Introductionmentioning

confidence: 99%

Real-time intraoperative 3D image intensifier-based navigation in reversed shoulder arthroplasty- analyses of image quality

Theopold

Pieroh

Henkelmann

et al. 2019

BMC Musculoskelet Disord

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Background Due to the high anatomical variability and limited visualization of the scapula, optimal screw placement for baseplate anchorage in reversed total shoulder arthroplasty (rTSA) is challenging. Image quality plays a key role regarding the decision of an appropriate implant position. However, these data a currently missing for rTSA and were investigated in the present study. Furthermore, the rate of required K-wire changes for the central peg as well as post-implantation inclination and version were assessed. Methods In ten consecutive patients (8 female, 86 years, range 74–94) with proximal humeral fracture and indication for rTSA, an intraoperative 3D-scan of the shoulder with a 3D image intensifier (Ziehm Vision FD Vario 3D© [Ziehm Imaging GmbH, Nürnberg, Germany]) was performed after resection of the humeral head. Using the Vectorvision© Software (Brainlab AG, Feldkirchen, Germany), the virtual anatomy was compared to the visible anatomical landmarks. After implantation of the baseplate, a 3D scan was performed. All 3D scans included multiplanar reconstruction (MPR) and the cinemode to examine screw and baseplate placement. The rate of required K-wire changes was assessed. The intraoperative 3D image quality (modified visual analogue scale [VAS] and point system) was assessed before and after implantation of the glenoid component. Inclination and version were determined in post-implantation scans. Results The virtually presented anatomical landmarks always correlated to the anatomical visible points indicating an good virtual accuracy. The central K-wire position was corrected in three cases due to a deviation from the face plane technique position. The VAS was higher for the pre-implantation MPR (6.7, range 5–8) compared to the post-implantation acquired MPR (5.1, range 4–6; p = 0.0002). The point system showed a reduced quality in all subcategories, especially regarding the grading of the articular surfaces. The preoperative (7.9, range 6–9) and post-implantation (7.9, range 6–9) cinemode displayed no significant differences ( p = 0.6). Conclusion The present study underlines the need for the improvement of 3D image intensifiers algorithms to reduce artifact associated impaired image quality to enhance the benefit of real-time intraoperative 3D scans and navigation.

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Benefit of intraoperative navigation on glenoid component positioning during total shoulder arthroplasty

Abstract: Level II-meta-analysis of non-homogenous controlled trials.

Cited by 47 publications

References 29 publications

Navegação em cirurgia de artroplastia de ombro

Navegação em cirurgia de artroplastia de ombro

Development and ex-vivo assessment of a novel patient specific guide and instrumentation system for minimally invasive total shoulder arthroplasty

Real-time intraoperative 3D image intensifier-based navigation in reversed shoulder arthroplasty- analyses of image quality

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