Outcomes of Guided Personalized Surgery (GPS)-Navigated Reverse Polarity Total Shoulder Joint Replacement in a...

Area of Science:

• Orthopedic Surgery
• Shoulder Arthroplasty
• Surgical Navigation

Background:

• Reverse polarity shoulder arthroplasty (RSA) indications are expanding beyond cuff tear arthropathy.
• Optimal glenoid base plate placement and fixation are critical for RSA success, preventing complications like loosening and dislocation.
• Distorted glenoid anatomy presents challenges for conventional RSA.

Purpose of the Study:

• To evaluate the efficacy of Guided Personalized Surgery (GPS)-navigated RSA in patients with challenging glenoid anatomy.
• To assess the impact of GPS navigation on glenoid base plate positioning and fixation.
• To analyze patient-reported outcomes and complication rates following GPS-navigated RSA.

Main Methods:

• Retrospective study of patients undergoing GPS-navigated RSA at a district general hospital.
• Analysis of preoperative glenoid version, bone stock, and implant dimensions.
• Collection of Oxford Shoulder Score (OSS) data preoperatively and postoperatively at six months and annually thereafter.

Main Results:

• Fourteen patients underwent GPS-navigated RSA, with 10 having retroverted glenoids requiring augmented base plates.
• Statistically significant improvement in OSS from preoperative values to six months (21.64±7.175), with continued progressive improvement.
• No dislocations or glenoid base plate loosening reported; four fractures occurred, comparable to literature.

Conclusions:

• GPS-navigated RSA is a viable option for selected patients, particularly those with distorted glenoid anatomy unsuitable for conventional RSA.
• The navigation system aids in achieving optimal glenoid base plate placement and fixation in complex cases.
• GPS-navigated RSA demonstrated favorable patient outcomes and a complication profile comparable to existing literature.