BACKGROUND:Glenoid replacement is challenging due to the difficult joint exposure and visualization of anatomical reference landmarks. Improper positioning of the glenoid component or inadequate correction of the retroversion using currently available instrumentation may lead to early failure. The objective of this study was to evaluate a computer-assisted technique to achieve a more accurate placement of the glenoid component compared to traditional techniques. METHODS:Sixteen paired cadaveric shoulders were randomized to either traditional or computer-assisted glenoid implantation. Preoperative planning consisting of CT scanning with 3-dimensional image modeling of the shoulder specimens and intraoperative tracking with real-time feedback provided to the surgeon was employed in the computer-assisted group. A validated, previously published, standardized protocol for tracking the orientation of the glenoid in space using 3 glenoid surface landmarks was employed. All phases of glenoid implantation (initial guide pin insertion, reaming, drilling of the peg holes, and final component implantation) were tracked and recorded by the computer. A post-implantation CT scan was performed in both groups to compare how accurately the implants were placed. RESULTS: The computer-assisted technique was more accurate in achieving the correct version during all phases of glenoid implantation and as measured on the post-implantation CT scan (P < .05). The largest errors with traditional glenoid implantation were observed during drilling and, more so, during reaming. The trend was to overly retrovert the glenoid. CONCLUSIONS: Computer assisted navigation results in a more accurate glenoid component placement relative to traditional techniques. LEVEL OF EVIDENCE: Basic Science Study.
RCT Entities:
BACKGROUND: Glenoid replacement is challenging due to the difficult joint exposure and visualization of anatomical reference landmarks. Improper positioning of the glenoid component or inadequate correction of the retroversion using currently available instrumentation may lead to early failure. The objective of this study was to evaluate a computer-assisted technique to achieve a more accurate placement of the glenoid component compared to traditional techniques. METHODS: Sixteen paired cadaveric shoulders were randomized to either traditional or computer-assisted glenoid implantation. Preoperative planning consisting of CT scanning with 3-dimensional image modeling of the shoulder specimens and intraoperative tracking with real-time feedback provided to the surgeon was employed in the computer-assisted group. A validated, previously published, standardized protocol for tracking the orientation of the glenoid in space using 3 glenoid surface landmarks was employed. All phases of glenoid implantation (initial guide pin insertion, reaming, drilling of the peg holes, and final component implantation) were tracked and recorded by the computer. A post-implantation CT scan was performed in both groups to compare how accurately the implants were placed. RESULTS: The computer-assisted technique was more accurate in achieving the correct version during all phases of glenoid implantation and as measured on the post-implantation CT scan (P < .05). The largest errors with traditional glenoid implantation were observed during drilling and, more so, during reaming. The trend was to overly retrovert the glenoid. CONCLUSIONS: Computer assisted navigation results in a more accurate glenoid component placement relative to traditional techniques. LEVEL OF EVIDENCE: Basic Science Study.
Authors: Eduardo M Suero; Musa Citak; Darrick Lo; Aaron J Krych; Edward V Craig; Andrew D Pearle Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-08-30 Impact factor: 4.342
Authors: Jonathan R Kusins; Jason A Strelzow; Marie-Eve LeBel; Louis M Ferreira Journal: Int J Comput Assist Radiol Surg Date: 2018-03-17 Impact factor: 2.924
Authors: Thomas Gregory; Ulrich Hansen; Roger Emery; Andrew A Amis; Celine Mutchler; Fabienne Taillieu; Bernard Augereau Journal: Acta Orthop Date: 2012-10 Impact factor: 3.717
Authors: Anne Karelse; Steven Leuridan; Alexander Van Tongel; Philippe Debeer; Jos Van Der Sloten; Kathleen Denis; Lieven F De Wilde Journal: J Orthop Surg Res Date: 2015-11-25 Impact factor: 2.359