Navigation-recorded plan execution in augmented total shoulder arthroplasty using the Advita GPS system and implant...

Computer-assisted navigation (CAN) is increasingly utilized in total shoulder arthroplasty (TSA), yet data validating its intra-operative agreement with pre-operative plans in glenoid deformities remain limited. This study evaluated the navigation-recorded execution of the pre-operative plan for glenoid entry point, version, and inclination in TSA treated with augmented glenoid components.

In this retrospective database study, we analyzed pre-operative computed tomography and intra-operative navigation reports from 19,054 navigated TSAs performed by 871 surgeons using the Advita GPS system and implant platform. Cohorts were subdivided by glenoid retroversion (GRV) ≥15° or <15° and glenoid inclination ≥10° or <10°. Plan deviations were calculated from the navigation-recorded entry point and central drill trajectory, used as surrogates for the final implant position, and compared by deformity severity and augment sub-type.

After excluding 189 cases (0.85%) with discontinued CAN, the cohort comprised 2,266 anatomic TSA (aTSA) and 16,788 reverse TSA (rTSA). In rTSA, GRV ≥15° showed marginally greater version deviation than GRV <15° although both groups remained approximately 0.3° from plan (P = .006). Entry-point deviations were statistically higher with GRV ≥15° and glenoid inclination ≥10° but remained approximately 1 mm across groups (P < .001 and P = .009, respectively). Posterior augments demonstrated higher version deviation than superior augments although both remained below 1° (P < .001). In aTSA, no sub-group differences were identified.

CAN showed close intra-operative agreement between the pre-operative plan and the navigation-recorded surrogate for the final implant position across augmented aTSA and rTSA irrespective of glenoid deformity severity. Statistically significant differences remained below thresholds of clinical relevance.