Impact of preoperative 3-dimensional planning and intraoperative navigation of shoulder arthroplasty on implant selection and operative time: a single surgeon's experience

Rosenthal, Yoav; Rettig, Samantha A.; Virk, Mandeep S.; Zuckerman, Joseph D.

doi:10.1016/j.jse.2020.03.041

Cited by 25 publications

(29 citation statements)

References 14 publications

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“…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 .…”

Section: Discussionsupporting

confidence: 74%

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

Greene¹,

Daviller²,

Polakovic³

et al.

EPiC Series in Health Sciences

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Two-year minimum clinical outcomes were collected on anatomic and reverse total shoulder arthroplasty patients enrolled in a single implant global registry that were performed using an intraoperative computer navigated surgery system. Age, gender, and follow-up matched cohorts were created from the same registry for comparison purposes for both anatomic and reverse total shoulder arthroplasty. The navigated cohorts exhibited as good or better clinical outcomes compared to the non-navigated cohorts as well as reductions in postoperative complications, revision rates, and adverse events.

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Section: Discussionsupporting

confidence: 74%

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

Greene¹,

Daviller²,

Polakovic³

et al.

EPiC Series in Health Sciences

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“…Most patients were female—62.67 and 63.07% for the NAV and CON groups, respectively. Although 70% of the studies 30,32,34,35,37-39 reported the preoperative glenoid morphology according to the Walch original or modified classification 40,41 , no study correlated any reported outcome of interest in reference to the Walch classification. Table II summarizes the demographic data from the included studies, preoperative glenoid assessment, and included diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…Another study arbitrarily set the cutoff value to establish competence when the surgeon became faster in performing the procedure 37 . The surgical volume of the surgeons was not reported in the studies included.…”

Section: Surgical Timementioning

confidence: 99%

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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“…In 2020, Rosenthal et al sought to determine whether intraoperative three-dimensional (3D) planning affected glenoid component selection and operative time [ 28 ]. They retrospectively studied 100 consecutive patients using two-dimensional (2D) planning and compared it with another 100 consecutive patients in which 3D planning was used.…”

Section: Reviewmentioning

confidence: 99%

“…Furthermore, they found that 23 CT-navigated cases were statistically similar to a matched group of 24 non-navigated, 77.3 minutes to 78.5 minutes, respectively, concluding that intraoperative computer navigation of glenoid component implantation does not increase the total surgical time for rTSA. The retrospective case series by Rosenthal et al of 200 consecutive shoulder arthroplasty patients found that at the institution of the technique, intraoperative navigation slightly increased the duration of surgery, but this became insignificant as part of a learning curve within six months [ 28 ]. Based on the results of these studies, it is likely that, when compared with standard surgical techniques, intraoperative computer navigation will not demand a significantly extended amount of added operative time.…”

Section: Reviewmentioning

confidence: 99%

A Systematic Review of the Utility of Intraoperative Navigation During Total Shoulder Arthroplasty

Eng¹,

Eyre-Brook²,

Shields³

2022

Cureus

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Total shoulder arthroplasty (TSA) has been demonstrated to successfully recover function to shoulders impaired by arthrosis and rotator cuff insufficiency. Long-term survival depends on the correct positioning of glenoid components and secure bone fixation. Computed tomography (CT)-based intraoperative navigation has proven to be an effective technique for successful TSA procedures. This paper presents a review of CT-based intraoperative navigation considering its advantages and disadvantages. The crucial factors that contribute to the success of this technique are glenoid component positioning, operative duration, and screw selection, which are detailed in this review.

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Impact of preoperative 3-dimensional planning and intraoperative navigation of shoulder arthroplasty on implant selection and operative time: a single surgeon's experience

Cited by 25 publications

References 14 publications

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

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

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

A Systematic Review of the Utility of Intraoperative Navigation During Total Shoulder Arthroplasty

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