[Image-based guidance in shoulder traumatology. Initial clinical experience]

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Surgical Navigation

Background:

• Computer-assisted systems are common in spine and pelvis surgery but underutilized in shoulder surgery due to imaging and marker challenges.
• Existing limitations include rigid markers and difficulties in obtaining navigable images in the intricate shoulder anatomy.

Purpose of the Study:

• To evaluate the efficacy of a novel image-based guidance system for shoulder traumatology.
• To assess the system's impact on surgical outcomes, radiation exposure, and workflow in treating acromioclavicular joint separations.

Main Methods:

• A prospective study comparing a new image-based guidance system with the conventional method for tightrope system implantation in Tossy III acromioclavicular joint lesions.
• Outcome measures included surgical duration, guide wire positioning trials, C-arm shots, radiation time, and surgeon feedback.
• The image-guided group included 7 patients, and the conventional group included 8 patients.

Main Results:

• The image-guided system did not significantly reduce overall surgical duration (45 vs. 49 minutes, p=0.6).
• Significant reductions were observed in the number of C-arm shots required (p=0.01) and guide wire positioning trials (p=0.02).
• Average radiation time decreased from 152 to 90 seconds (p=0.3), and surgeons reported positive usability and benefits.

Conclusions:

• Image-based guidance is feasible and beneficial in shoulder traumatology for the first time.
• The system aids surgeons by improving guide wire accuracy, reducing critical errors, and lowering radiation exposure without disrupting workflow.
• This technology holds significant potential for enhancing safety and efficiency in shoulder trauma surgery.