Pre-Operative CT-Based Planning Integrated With Intra-Operative Navigation in Reverse Shoulder Arthroplasty: Data...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Surgical Navigation

Background:

• Reverse total shoulder arthroplasty (RSA) is effective for shoulder restoration.
• Glenoid baseplate fixation and positioning are critical for RSA success.
• Scapular anatomy distortion complicates optimal baseplate placement and screw purchase.

Purpose of the Study:

• To evaluate if CT-based pre-operative planning with intra-operative navigation improves glenoid baseplate fixation and positioning in RSA.
• To assess if navigation increases screw length, reduces screw number, and increases augmented baseplate use.

Main Methods:

• Retrospective comparison of 20 navigated RSA patients versus 20 conventionally operated patients.
• All procedures performed by the same surgeon using the same implant.
• Analysis of screw length, number of screws for fixation, and augmented baseplate usage.

Main Results:

• Navigation group showed significantly longer mean screw length (35.5 ± 4.4 mm vs 29.9 ± 3.6 mm, p = .001).
• Navigation group had a higher rate of optimal fixation with two screws (17 vs 3 cases, p = .019).
• Navigation group demonstrated increased augmented baseplate usage (13 vs 4 cases, p = .009).

Conclusions:

• Pre-operative CT-based planning with intra-operative navigation enhances glenoid component positioning and fixation in RSA.
• Improved fixation and positioning may lead to better RSA implant survival rates.
• Navigated RSA offers advantages in managing complex scapular anatomy.