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Reliability of 3-Dimensional Glenoid Component Templating and Correlation to Intraoperative Component Selection
Comron Saifi, Manish N Noticewala1, R Michael Greiwe
1Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY. manish.s.noticewala@gmail.com.
American Journal of Orthopedics (Belle Mead, N.J.)
|November 4, 2017
Summary
This study demonstrates that 3-dimensional digital imaging reliably aids in preoperative templating of glenoid component size for total shoulder arthroplasty (TSA). This method shows promise for improving surgical planning and component selection in TSA procedures.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Biomechanical Engineering
Background:
- Preoperative planning for total shoulder arthroplasty (TSA) lacks a validated digital imaging method for glenoid component sizing.
- Existing intraoperative targeting devices are implant-specific, highlighting a need for improved preoperative templating solutions.
Purpose of the Study:
- To determine the feasibility of using 3-dimensional (3-D) digital imaging for preoperative glenoid component size templating in primary TSA.
- To compare the accuracy of templated glenoid sizes with the actual implanted sizes.
Main Methods:
- Creation of 3-D digital models from computed tomography (CT) scans of 24 patients undergoing primary TSA.
- Surgeons performed templating using 2 degrees of freedom (df) (superior-inferior, anterior-posterior) and 6 df (including rotational planes).
- Assessment of intraobserver and interobserver agreement for templating accuracy.
Main Results:
- Substantial intraobserver agreement was found in the 2-df arm (0.67) and moderate agreement in the 6-df arm (0.58).
- Interobserver agreement was fair in the 2-df arm (0.32-0.36) and moderate in the 6-df arm (0.43-0.54).
- Surgeons tended to template smaller glenoid components than those implanted, especially for female patients.
Conclusions:
- 3-D digital models provide a consistent and reliable method for preoperative glenoid component size templating in primary TSA.
- This approach has the potential to enhance surgical precision and patient outcomes in shoulder arthroplasty.
- Further refinement may be needed to address size discrepancies, particularly in specific patient demographics.
