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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.
Objective:
To verify whether reverse baseplate positioning without the support of intraoperative three-dimensional technology is within the acceptable parameters in the literature and whether glenoid bone deformity (GBD) compromises this positioning.
Methods:
Sixty-nine reverse shoulder arthroplasties were evaluated with volumetric computed tomography (CT). Two radiologists performed blinded CT scan analysis and evaluated baseplate position within 2mm of the inferior glenoid; the inclination and version of the baseplate in relation to the Friedman line; and upper and lower screw and baseplate metallic peg end point positionings. The patients were divided according to the presence of GBD for statistical analyses.
Results:
The two radiologists concurred reasonably in their interpretations of the following analyzed parameters: baseplate position within 2mm of the inferior glenoid rim (97.1% and 95.7%), baseplate inclination (82.6% and 81.2%), baseplate version (69.6% and 56.5%), the upper screw reaching the base of the coracoid process (71% and 79.7%), the inferior screw remaining inside the scapula (88.4% and 84.1%), and the metallic peg of the baseplate considered intraosseous (88.4% and 72.5%).
Conclusion:
Reverse baseplate positioning without intraoperative three-dimensional technology is within the acceptable parameters of the literature, except for baseplate version and upper screw position. GBD did not interfere with baseplate positioning in reverse shoulder arthroplasty.
