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Variability in preoperative planning software for shoulder arthroplasty.

Ana R Senra1,2, Diogo Tomaz1,2, Diogo S Gomes3,4

  • 1Unidade Local de Saúde São João, Porto, Portugal.

JSES International
|May 6, 2026
PubMed
Summary
This summary is machine-generated.

Preoperative planning software for shoulder arthroplasty shows significant variability, especially in glenoid inclination measurements. Standardization is crucial for reliable surgical planning and reproducible outcomes in shoulder replacement procedures.

Keywords:
Intersoftware reliabilityPatient-specific instrumentationPlanning software variabilityPreoperative planningShoulder arthroplastyShoulder arthroplasty planning

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Medical imaging analysis

Background:

  • Three-dimensional (3D) preoperative planning is vital for optimizing implant selection and component positioning in shoulder arthroplasty.
  • Current planning platforms utilize automated best-fit sphere or manual landmark-based methods, which can introduce variability in glenoid morphology assessment.
  • Understanding inter-software variability is essential for consistent and accurate surgical planning.

Purpose of the Study:

  • To compare the performance of five commercially available 3D preoperative planning platforms for shoulder arthroplasty.
  • To determine if differences in analytical algorithms contribute to inter-software variability in glenoid morphology assessment.
  • To evaluate the reliability and reproducibility of different planning software in measuring glenoid version, inclination, and humeral head subluxation.

Main Methods:

  • Thirty-three patients undergoing shoulder arthroplasty were included in the study.
  • Preoperative computed tomography (CT) scans were analyzed using five distinct planning platforms: Blueprint, Equinoxe, Signature ONE, MyShoulder, and LimaCorporate.
  • Key glenoid parameters including version, inclination, and humeral head subluxation were assessed, with data analyzed for group and pairwise comparisons between software.

Main Results:

  • Significant inter-platform differences were observed for glenoid version (P < .001), inclination (P = .015), and subluxation (P = .032).
  • Intraclass correlation coefficients (ICCs) indicated high agreement for subluxation (0.826) and moderate to high agreement for version (0.749), but low agreement for inclination (0.267).
  • Pairwise agreement varied widely, with version agreement ranging from 45.5% to 97% and inclination agreement from 30.3% to 90.9%.

Conclusions:

  • Substantial variability exists between different preoperative shoulder arthroplasty planning software, particularly impacting glenoid inclination measurements.
  • Automated software showed higher concordance for version but lower concordance for subluxation, indicating algorithmic differences influence results.
  • Methodological standardization across planning platforms is crucial to enhance the reliability and reproducibility of shoulder arthroplasty planning and surgical outcomes.