Archives of Orthopaedic and Trauma Surgery

, Volume 135, Issue 1, pp 41–47 | Cite as

Benefit of intraoperative navigation on glenoid component positioning during total shoulder arthroplasty

  • Patrick SadoghiEmail author
  • Julia Vavken
  • Andreas Leithner
  • Patrick Vavken
Orthopaedic Surgery



The objective of this study was to review and synthesize the current best evidence for the use of intraoperative navigation in the implantation of glenoid components in total shoulder prostheses.


We conducted a systematic, online search using PubMed, EMBASE, CCTR, and CINAHL using “Arthroplasty, Replacement”(Mesh) AND (shoulder) AND (navi* OR computer). Data on study design and quality as well as accuracy of positioning and complications were extracted independently and in duplicate. After assessment of study heterogeneity, DerSimonian-Laird random effect models were used to pool data from the individual studies.


The systematic search revealed 359 manuscripts in total. After exclusion of duplicates and irrelevant publications, 6 groups of 247 shoulders from 5 studies were included. The pooled weighted mean difference for deviation from neutral version was −6.4° (95 %CI −7.9 to −5.3) in favor of navigation, which is consistent with a statistically significant difference (p < 0.01). In the navigation group, 2 superior glenoid screws were reported as perforating compared to 5 screws (1 inferior, 4 superior) in the control group. There was no difference in tilt at a WMD of 2.7 (95 %CI −1.4 to 6.8, p = 0.192).


Navigation allows for significantly more accurate glenoid version, but the clinical meaningfulness of the absolute improvement over standard techniques is questionable. However, navigation is a valuable teaching tool that might prove very beneficial not for the patient at hand, but for those treated by the operating surgeon in the future.

Level of evidence

Level II—meta-analysis of non-homogenous controlled trials.


Total shoulder arthroplasty Glenoid Computer-assisted navigation 



This project was funded by the “Forschungsförderung 2012” of the Association for Orthopaedic Research (AFOR).

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Patrick Sadoghi
    • 1
    Email author
  • Julia Vavken
    • 2
  • Andreas Leithner
    • 1
  • Patrick Vavken
    • 2
    • 3
    • 4
  1. 1.Department of Orthopedic SurgeryMedical University of GrazGrazAustria
  2. 2.Department of Orthopaedic SurgeryUniversity Hospital BaselBaselSwitzerland
  3. 3.Division of Sports Medicine, Department of Orthopedic SurgeryBoston Children’s Hospital, Harvard Medical SchoolBostonUSA
  4. 4.Harvard Center for Population and Development StudiesHarvard School of Public HealthBostonUSA

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