Patient-specific planning in shoulder arthroplasty.

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Surgical Planning

Background:

• Patient-specific instrumentation enhances precision in shoulder arthroplasty.
• Limited data exists on the impact of patient-specific planning (PSP) tools on surgical decision-making.

Purpose of the Study:

• To evaluate how PSP influences surgeons' understanding of glenoid pathology and surgical planning.
• To compare PSP with traditional imaging methods like radiographs and static CT scans.

Main Methods:

• A survey presented surgeons with patient cases, sequentially showing radiographs, static CT images, and PSP with 3D imaging.
• Surgeons classified glenoid pathology (Walch classification) and proposed treatment for each imaging modality.
• Responses were compared with expert recommendations and analyzed based on surgeon volume.

Main Results:

• PSP significantly increased agreement with expert glenoid classification and surgical planning across all surgeons.
• The impact of PSP on decision-making was significantly greater for surgeons performing fewer than ten shoulder arthroplasties annually.
• 59 surgeons completed the survey, with statistically significant improvements noted (p < 0.014 for classification, p < 0.001 for planning).

Conclusions:

• Patient-specific planning (PSP) enhances surgical decision-making, especially for lower-volume surgeons.
• PSP aligns all surgeons' glenoid classification and surgical planning more closely with expert consensus.
• The study highlights PSP's value in improving consistency and accuracy in shoulder arthroplasty planning.