Patient-Specific Guides/Instrumentation in Shoulder Arthroplasty

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Surgical instrumentation

Background:

• Optimal outcomes in total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) depend critically on precise implant positioning.
• Cadaver studies suggest patient-specific instrumentation (PSI) enhances accuracy over traditional methods for glenoid placement.

Purpose of the Study:

• To review the current landscape of patient-specific instrumentation systems for shoulder arthroplasty.
• To identify the need for clinical outcome studies comparing PSI to traditional methods.
• To highlight the potential of PSI in complex cases, such as advanced glenoid deformity.

Main Methods:

• Review of existing literature on patient-specific instrumentation for TSA and RSA.
• Analysis of available commercial PSI systems (single-use and reusable).
• Identification of research gaps in clinical outcome and 3D planning software accuracy comparisons.

Main Results:

• Multiple PSI systems are commercially available for shoulder arthroplasty.
• Evidence from cadaver studies supports improved accuracy with PSI.
• A significant lack of clinical outcome data comparing PSI to traditional methods exists.

Conclusions:

• Patient-specific instrumentation shows promise for improving implant accuracy in shoulder arthroplasty.
• Further clinical studies are necessary to validate the benefits of PSI.
• PSI may be particularly beneficial for surgeons managing complex glenoid deformities.