Accuracy of Glenoid Component Positioning in Reverse Shoulder Arthroplasty: A Biomechanical Comparison between 3D Preoperative Planning, PSI, Computer-Assisted Navigation, and Mixed Reality Navigation

5 pages•Published: December 17, 2024

Cole Fleet, Ryan Gao, Daniel Langohr, James Johnson and George Athwal

Abstract

Accurate glenoid component positioning in shoulder arthroplasty is important to avoid potential impingement, loosening, and instability. Several techniques are currently utilized to assist in glenoid guide pin positioning, although no studies exist that directly compare the accuracy between these techniques. The objective of this study was to compare guide pin insertion accuracy using traditional 3D software planning (TSP), patient specific instrumentation (PSI) guides, computer-navigation (C- NAV), and mixed reality navigation (MR-NAV).
Twenty shoulder computer tomography scans exhibiting glenohumeral arthritis or rotator cuff tear arthropathy were preoperatively planned for reverse shoulder arthroplasty. Quadruplicate models of each glenoid were plastic 3D printed and were used to randomly assess four guide pin insertion techniques by a fellowship trained surgeon as follows: (1) TSP, (2) PSI guides, (3) C-NAV, and (4) MR-NAV. Following guide pin placement, the absolute error in guide pin position and orientation relative to the preoperative plan was measured using a digitization system.
Similar inclination (P>0.066) and version (P>0.515) accuracy occurred between PSI, C-NAV, and MR-NAV techniques. Furthermore, all three methods exhibited significantly less error in guide pin inclination compared to TSP (P<0.025). Greater version error was also observed with TSP (4±3°) but was not significantly greater than the other techniques (P>0.063). The error in guide pin entry point was similar between all four methods utilized (P>0.086).
This study showed that the accuracy of PSI, C-NAV, and MR-NAV are superior to TSP for glenoid pin insertion in-vitro. Further investigation is needed to validate the accuracy of all guide pin insertion techniques in-vivo.

Keyphrases: alignment, implants, navigation, orthopaedics, shoulder

In: Joshua W Giles and Aziliz Guezou-Philippe (editors). Proceedings of The 24th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 7, pages 75-79.

Links:	https://easychair.org/publications/paper/mW9Kf
	https://doi.org/10.29007/5vbq

BibTeX entry

@inproceedings{CAOS2024:Accuracy_Glenoid_Component_Positioning,
  author    = {Cole Fleet and Ryan Gao and Daniel Langohr and James Johnson and George Athwal},
  title     = {Accuracy of Glenoid Component Positioning in Reverse Shoulder Arthroplasty: A Biomechanical Comparison between 3D Preoperative Planning, PSI, Computer-Assisted Navigation, and Mixed Reality Navigation},
  booktitle = {Proceedings of The 24th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Joshua W Giles and Aziliz Guezou-Philippe},
  series    = {EPiC Series in Health Sciences},
  volume    = {7},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/mW9Kf},
  doi       = {10.29007/5vbq},
  pages     = {75-79},
  year      = {2024}}

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