David M Burns1,2, Tym Frank1, Cari M Whyne2, Patrick Dg Henry1,3. 1. Division of Orthopaedic Surgery, University of Toronto, Toronto, Canada. 2. Sunnybrook Research Institute, Toronto, Canada. 3. Sunnybrook Health Sciences Centre, Toronto, Canada.
Abstract
BACKGROUND: Positioning of the glenoid component is one of the most challenging steps in shoulder arthroplasty, and prosthesis longevity as well as functional outcomes is considered highly dependent on accurate positioning. This review considers the evidence supporting surgical navigation and patient-specific instruments for glenoid implant positioning in anatomic and reverse total shoulder arthroplasty. METHODS: A systematic literature search was performed for studies assessing glenoid implant positioning accuracy as measured by cross-sectional imaging on live subjects or cadaver models. Meta-analysis of controlled studies was performed to estimate the primary effects of navigation and patient-specific instruments on glenoid implant positioning error. Meta-analysis of absolute positioning outcomes was also performed for each group incorporating data from controlled and uncontrolled studies. RESULTS: Nine studies, four controlled and five uncontrolled, with 258 total subjects were included in the analysis. Meta-analysis of controlled studies supported that both navigation and patient-specific instruments had a moderate statistically significant effect on improving glenoid implant positioning outcomes. Meta-analysis of absolute positioning outcomes demonstrates glenoid implant positioning with standard instrumentation results in a high rate of malposition. DISCUSSION: Navigation and patient-specific instruments improve glenoid positioning outcomes. Whether the improvement in positioning outcomes achieved translate to better clinical outcomes is unknown.
BACKGROUND: Positioning of the glenoid component is one of the most challenging steps in shoulder arthroplasty, and prosthesis longevity as well as functional outcomes is considered highly dependent on accurate positioning. This review considers the evidence supporting surgical navigation and patient-specific instruments for glenoid implant positioning in anatomic and reverse total shoulder arthroplasty. METHODS: A systematic literature search was performed for studies assessing glenoid implant positioning accuracy as measured by cross-sectional imaging on live subjects or cadaver models. Meta-analysis of controlled studies was performed to estimate the primary effects of navigation and patient-specific instruments on glenoid implant positioning error. Meta-analysis of absolute positioning outcomes was also performed for each group incorporating data from controlled and uncontrolled studies. RESULTS: Nine studies, four controlled and five uncontrolled, with 258 total subjects were included in the analysis. Meta-analysis of controlled studies supported that both navigation and patient-specific instruments had a moderate statistically significant effect on improving glenoid implant positioning outcomes. Meta-analysis of absolute positioning outcomes demonstrates glenoid implant positioning with standard instrumentation results in a high rate of malposition. DISCUSSION: Navigation and patient-specific instruments improve glenoid positioning outcomes. Whether the improvement in positioning outcomes achieved translate to better clinical outcomes is unknown.
Entities:
Keywords:
glenoid; image-guided surgery; patient-specific instruments; reverse total shoulder arthroplasty; surgical navigation; total shoulder arthroplasty
Authors: Richard W Nyffeler; Bernhard Jost; Christian W A Pfirrmann; Christian Gerber Journal: J Shoulder Elbow Surg Date: 2003 Sep-Oct Impact factor: 3.019
Authors: Julia K Frank; Paul Siegert; Fabian Plachel; Philipp R Heuberer; Stephanie Huber; Jakob E Schanda Journal: J Clin Med Date: 2022-03-10 Impact factor: 4.241