Testing of a novel pin array guide for accurate three-dimensional glenoid component positioning

Lewis, Gregory S.; Stevens, Nicole; Armstrong, April

doi:10.1016/j.jse.2015.06.022

Cited by 23 publications

(17 citation statements)

References 23 publications

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“…Although this may not perfectly simulate TSA operative conditions, our intent was to perform a controlled evaluation in a cadaveric model before it can be tested a clinical environment because this device has not previously been described in the literature. Previous studies have evaluated patient-specific systems in TSA by using Sawbones (Vashon, WA, USA) or polymer scapular models, as well as cadaveric scapular specimens without any associated soft tissue 1, 9, 19, 24, 34. In addition, we were unable to specifically request and obtain cadaveric specimens with glenohumeral osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…Our power analysis determined that a sample size of 20 specimens was necessary for the purposes of this investigation, which is greater than that in the majority of available cadaveric or clinical studies investigating the impact of PSI devices on TSA 2, 9, 22, 23, 24, 27, 28, 29, 32, 34. Although it is impossible to represent the entire spectrum of TSA patients with this sample, the addition of a standard instrumentation control adds further validity that was absent in several previous investigations 2, 13, 23, 27, 32, 34.…”

Section: Discussionmentioning

confidence: 99%

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Novel 3-dimensionally printed patient-specific guide improves accuracy compared with standard total shoulder arthroplasty guide: a cadaveric study

et al. 2019

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Background Patient-specific instrumentation (PSI) systems for total shoulder arthroplasty (TSA) can improve glenoid component placement, but may involve considerable expense and production delays. The purpose of this study was to evaluate a novel technique for in-house production of 3-dimensionally printed, patient-specific glenoid guides. We hypothesized that our PSI guide would improve the accuracy of glenoid guide pin placement compared with a standard TSA guide. Methods We randomized 20 cadaveric shoulders to receive pin placement via the PSI guide (n = 10, study group) or standard TSA guide (n = 10, control group). PSI guides were designed to fit each glenoid based on 3-dimensional scapular models constructed from computed tomography scans. A presurgical plan was created for the guide pin trajectory in neutral version and inclination based on individual scapular anatomy. After pin placement, 3-dimensional models from repeated computed tomography scans were superimposed to calculate deviation from the presurgical plan for each specimen. Results Inclination deviation was significantly lower in the PSI group than in the standard guide group (1.5° ± 1.6° vs. 6.4° ± 5.0°, P = .009). The glenoid entry site exhibited significantly less deviation in the PSI group (0.8 ± 0.6 mm vs. 2.1 ± 1.2 mm, P = .008). The average production cost and time for the PSI guides were $29.95 and 4 hours 40 minutes per guide, respectively. Conclusions The PSI guide significantly improved the accuracy of glenoid pin placement compared with the standard TSA guide. Our PSI guides can be produced in-house, inexpensively, and with substantially reduced time compared with commercially available guides.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Novel 3-dimensionally printed patient-specific guide improves accuracy compared with standard total shoulder arthroplasty guide: a cadaveric study

et al. 2019

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“…In a study of Iannotti et al , 24 on bone models, the accuracy of pin positioning using PSI compared with use of standard instrumentation increased by 3.7°± 0.9° in version, 8.1±1.2° in inclination, and 1.2±0.2 mm in location. Lewis et al , 25 in 2015 affirmed that version and inclination errors using the pin array guide on polymer models of glenoids were significantly lower compared with no assistance. In a study of Walch et al , 26 on cadaveric scapulae the mean error in 3D orientation of the guide pin compared with the preoperative planning was 2.39°, the mean entry point position error was 1.05 mm, the mean inclination angle error was 1.42° and the average error in the version angle was 1.64°.…”

Section: D Printing: How Does It Work?mentioning

confidence: 99%

3D printing in shoulder surgery

Campana¹,

Cardona²,

Vismara³

et al. 2020

Orthop Rev (Pavia)

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Three-dimensional (3D) printing is a novel modality with the potential to make a huge impact in the surgical field. The aim of this paper is to provide an overview on the current use of 3D printing in shoulder surgery. We have reviewed the use of this new method in 3 fields of shoulder surgery: shoulder arthroplasty, recurrent shoulder instability and orthopedic shoulder traumatology. In shoulder arthroplasty, several authors have shown that the use of the 3D printer improves the positioning of the glenoid component, even if longer clinical follow-up is needed to determine whether the cost of this system rationalizes the potential improved functional outcomes and decreases glenoid revision rates. In the treatment of anterior shoulder instability, the literature agrees on the fact that the use of the 3D printing can: enhance the dept and size of bony lesions, allowing a patient tailored surgical planning and potentially reducing operative times; allow the production of personalized implants to restore substantial bone loss; restore glenohumeral morphology and instability. In orthopedic trauma, the use of 3D printing can be helpful to increase the understanding of fracture patterns, facilitating a more personalized planning, and can be used for resident training and education. We can conclude the current literature regarding the use of 3D printed models in orthopedic surgery agrees finding objective improvements to preoperative planning and to the surgical procedure itself, by shortening the intraoperative time and by the possibility to develop custom-made, patient-specific surgical instruments, and it suggests that there are tangible benefits for its implementation.

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“…In patients with a high degree of bone loss that is not correctable or with substantial joint instability, reverse total shoulder arthroplasty (RTSA) is often used. To address these difficult deformities, patient-specific instrumentation has gained traction recently [42][43][44][45][46][47], with companies beginning to explore patient-specific implants as surgical options to replace population-based implant designs (Stanmore Implants, Zimmer, Mobelife). The following sections address the specific arthroplasty options.…”

Section: Arthroplasty Optionsmentioning

confidence: 99%

“…The focus of current patient-specific literature in the shoulder has been on the increased accuracy of component placement with patient-specific positioning guides and 3D pre-operative templating. Improved glenoid component positioning accuracy, compared to traditional techniques, has been reported for standard and augmented components [47,[64][65][66] and in baseplate positioning in RTSA procedures [67]. These devices are possible due to advancements in medical imaging software, 3D printing technologies, and improved knowledge of the osteoarthritic joint.…”

Section: Patient-specific Optionsmentioning

confidence: 99%

The arthritic glenoid: anatomy and arthroplasty designs

Knowles

Ferreira

Athwal

2016

Curr Rev Musculoskelet Med

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The number of shoulder arthroplasty procedures has increased dramatically in recent years, with the primary indication being osteoarthritis (OA). Thus, morphology and subchondral bone changes associated with OA may be important factors to consider when choosing a replacement component. For surgical treatment, many implant options exist and survivability is often dependent on patient age, activity level, and progression of OA. In the placement of these replacement components, patient-specific guides now exist to improve component positioning, with the goal to improve long-term survivability by ensuring that intra-operative placement meets component design.

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Testing of a novel pin array guide for accurate three-dimensional glenoid component positioning

Cited by 23 publications

References 23 publications

Novel 3-dimensionally printed patient-specific guide improves accuracy compared with standard total shoulder arthroplasty guide: a cadaveric study

Novel 3-dimensionally printed patient-specific guide improves accuracy compared with standard total shoulder arthroplasty guide: a cadaveric study

3D printing in shoulder surgery

The arthritic glenoid: anatomy and arthroplasty designs

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