Augmented reality for base plate component placement in reverse total shoulder arthroplasty: a feasibility study

Area of Science:

• Orthopedic Surgery
• Medical Technology
• Surgical Navigation

Background:

• Accurate glenoid positioning is critical for successful reverse total shoulder arthroplasty (RSA) outcomes.
• Severe glenoid deformities present challenges for optimal component placement.
• Augmented reality (AR) offers a potentially low-cost, user-friendly alternative to existing navigation methods like patient-specific instruments (PSI) and 3D computer-assisted optical tracking navigation (NAV).

Purpose of the Study:

• To introduce and evaluate a new augmented reality (AR) based navigation technique for surgical guidance in reverse total shoulder arthroplasty (RSA).
• To assess the feasibility of using AR via a head-mounted display for enhancing surgical planning and precision in RSA.

Main Methods:

• Ten human cadaver scapulae underwent 3D surface model printing from CT data.
• Preoperative planning defined the guidewire trajectory for glenoid baseplate positioning.
• AR technology projected a holographic guidewire onto 3D scapula models, with registration via optical tracking. Post-placement CT scans analyzed deviations from the plan.

Main Results:

• The mean deviation in guidewire trajectory from the planned path was 2.7° (±1.3°).
• The mean deviation in guidewire entry point from the planned position was 2.3 mm (±1.1 mm).
• These results indicate high precision in navigated guidewire placement.

Conclusions:

• Augmented reality (AR) demonstrates potential as a highly precise technology for executing 3D preoperative plans in reverse total shoulder arthroplasty (RSA).
• AR may enhance surgical accuracy and improve outcomes in complex shoulder arthroplasty cases.