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Tomographic Analysis of Positioning of Reverse Baseplates Positioning.

Alexandre Almeida1, Daniel C Agostini2, Pietro Ft Nesello1

  • 1Orthopaedic Surgeon, Pompeia Hospital, Caxias do Sul, Brazil.

Journal of Shoulder and Elbow Arthroplasty
|September 9, 2021
PubMed
Summary

Reverse shoulder arthroplasty baseplate positioning without 3D technology is generally acceptable, except for version and upper screw placement. Glenoid bone deformity does not impact positioning accuracy.

Keywords:
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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Accurate reverse baseplate positioning is crucial for successful reverse shoulder arthroplasty (RSA).
  • Intraoperative 3D technology is often used to guide baseplate placement.
  • The impact of glenoid bone deformity (GBD) on positioning accuracy is not fully understood.

Purpose of the Study:

  • To evaluate the accuracy of reverse baseplate positioning without intraoperative 3D guidance.
  • To determine if GBD affects the accuracy of baseplate positioning in RSA.

Main Methods:

  • Volumetric CT scans of 69 RSA cases were analyzed by two blinded radiologists.
  • Evaluated parameters included baseplate proximity to the inferior glenoid rim, inclination, version, screw positioning, and peg intraosseous placement.
  • Patients were stratified based on the presence or absence of GBD.

Main Results:

  • High inter-radiologist agreement was observed for baseplate position (95.7-97.1%) and inclination (81.2-82.6%).
  • Acceptable positioning was noted for baseplate proximity to the inferior glenoid rim and inferior screw placement.
  • Baseplate version (56.5-69.6%) and upper screw positioning (71-79.7%) were less consistently within acceptable parameters.
  • GBD did not significantly affect baseplate positioning accuracy.

Conclusions:

  • Reverse baseplate positioning without 3D technology is largely within acceptable limits, with exceptions in version and upper screw placement.
  • GBD does not appear to compromise the accuracy of reverse baseplate positioning in RSA.
  • Further refinement of techniques for version and upper screw placement may be beneficial.