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Shoulder patient-specific guide: First experience in 10 patients indicates room for improvement
J Berhouet1, M Rol2, C Spiry2
1Service d'orthopédie traumatologie, faculté de médecine de Tours, université François-Rabelais-de-Tours, CHRU Trousseau, 1C, avenue de la République, 37170 Chambray-Les-Tours, France; Équipe reconnaissance de forme et analyse de l'image, laboratoire d'informatique EA6300, école d'ingénieurs polytechnique universitaire de Tours, université François-Rabelais-de-Tours, 64, avenue Portalis, 37200 Tours, France.
Patient-specific guides (PSGs) for total shoulder arthroplasty (TSA) showed inaccuracies in glenoid component rotation and reaming. Further PSG design improvements are needed for precise glenoid positioning in shoulder replacement surgery.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Medical Device Design
Background:
- Total shoulder arthroplasty (TSA) involves glenoid component implantation.
- Patient-specific guides (PSGs) aim to replicate preoperatively planned glenoid positions.
- Assessing PSG reliability and accuracy in TSA is crucial for surgical outcomes.
Purpose of the Study:
- To evaluate the accuracy of patient-specific guides (PSGs) in replicating planned glenoid component positioning during total shoulder arthroplasty (TSA).
- To identify areas for improvement in 3D preoperative planning and PSG design for glenoid component placement.
Main Methods:
- A prospective cohort study involving 10 patients undergoing TSA with PSGs.
- Preoperative 3D planning was used for PSG design and glenoid component positioning.
- Postoperative measurements of glenoid version, tilt, rotation, global 3D position, and pilot hole accuracy were compared to planned values.
Main Results:
- Mean errors observed: -1.7°±4.4° for version, -0.4°±4.9° for tilt, and 6.0°±13.5° for rotation.
- Mean global orientation difference was 4.9°±2.5° compared to planned values.
- Mean 3D discrepancy in pilot hole position was 2.9±0.5mm, with greater mediolateral error.
Conclusions:
- The current PSG design demonstrated limitations in controlling glenoid component rotation and reaming accuracy.
- Discrepancies between planned and achieved global glenoid position suggest areas for PSG design enhancement.
- Future PSG development should focus on improving rotational control and reaming accuracy for better glenoid positioning in TSA.
