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The precision of patient-specific instrumentation guides for the positioning of the glenoid component in total reverse shoulder arthroplasty: an in vivo scanographic study

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Abstract

Objective

Optimal position and fixation of the baseplate is essential for the longevity of the reverse shoulder arthroplasty (RSA) and the patient-specific instrumentation (PSI) can help the surgeon to achieve that purpose. The aim of this study was to assess the reliability of the PSI guides for the positioning of the baseplate and the fixation’s screws.

Method

Prospective study involving 35 patients operated for RSA. The PSI guides were planned and used by the senior surgeon in all cases. We compared the planned orientation (frontal and axial) of the baseplate and the screws with the post-operative CT scan.

Results

The mean difference between the planned measures and the post-op measures was inferior to 2.5°. The screw’s length corresponded with the pre-op plan in 70% of the cases.

Conclusion

The use of a PSI guide to position the glenoid implant in total reverse shoulder arthroplasty is reliable, reduces the risk of positioning errors and improves the quality of fixation with the screws.

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References

  1. Boileau P, Watkinson D, Hatzidakis AM, Hovorka I (2006) Neer award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elb Surg 15(5):527–540. https://doi.org/10.1016/j.jse.2006.01.003

    Article  Google Scholar 

  2. Favard L, Levigne C, Nerot C, Gerber C, De Wilde L, Mole D (2011) Reverse prostheses in arthropathies with cuff tear: are survivorship and function maintained over time? Clin Orthop Relat Res 469(9):2469–2475. https://doi.org/10.1007/s11999-011-1833-y

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg (Br) 86(3):388–395

    Article  CAS  Google Scholar 

  4. de Wilde LF, Poncet D, Middernacht B, Ekelund A (2010) Prosthetic overhang is the most effective way to prevent scapular conflict in a reverse total shoulder prosthesis. Acta Orthop 81(6):719–726. https://doi.org/10.3109/17453674.2010.538354

    Article  PubMed  PubMed Central  Google Scholar 

  5. Friedman RJ, Barcel DA, Eichinger JK (2019) Scapular notching in reverse total shoulder arthroplasty. J Am Acad Orthop Surg 27(6):200–209. https://doi.org/10.5435/JAAOS-D-17-00026

    Article  PubMed  Google Scholar 

  6. Katz D, Valenti P, Kany J, Elkholti K, Werthel JD (2016) Does lateralisation of the Centre of rotation in reverse shoulder arthroplasty avoid scapular notching? Clinical and radiological review of one hundred and forty cases with forty five months of follow-up. Int Orthop 40(1):99–108. https://doi.org/10.1007/s00264-015-2976-3

    Article  PubMed  Google Scholar 

  7. Eraly K, Stoffelen D, Vander Sloten J, Jonkers I, Debeer P (2016) A patient-specific guide for optimizing custom-made glenoid implantation in cases of severe glenoid defects: an in vitro study. J Shoulder Elb Surg 25(5):837–845. https://doi.org/10.1016/j.jse.2015.09.034

    Article  Google Scholar 

  8. Levy JC, Everding NG, Frankle MA, Keppler LJ (2014) Accuracy of patient-specific guided glenoid baseplate positioning for reverse shoulder arthroplasty. J Shoulder Elb Surg 23(10):1563–1567. https://doi.org/10.1016/j.jse.2014.01.051

    Article  Google Scholar 

  9. Walch G, Vezeridis PS, Boileau P, Deransart P, Chaoui J (2015) Three-dimensional planning and use of patient-specific guides improve glenoid component position: an in vitro study. J Shoulder Elb Surg 24(2):302–309. https://doi.org/10.1016/j.jse.2014.05.029

    Article  Google Scholar 

  10. Dallalana RJ, McMahon RA, East B, Geraghty L (2016) Accuracy of patient-specific instrumentation in anatomic and reverse total shoulder arthroplasty. Int J Shoulder Surg 10(2):59–66. https://doi.org/10.4103/0973-6042.180717

    Article  PubMed  PubMed Central  Google Scholar 

  11. Heylen S, Van Haver A, Vuylsteke K, Declercq G, Verborgt O (2016) Patient-specific instrument guidance of glenoid component implantation reduces inclination variability in total and reverse shoulder arthroplasty. J Shoulder Elb Surg 25(2):186–192. https://doi.org/10.1016/j.jse.2015.07.024

    Article  Google Scholar 

  12. Iannotti JP, Ricchetti ET, Rodriguez EJ, Bryan JA (2013) Development and validation of a new method of 3-dimensional assessment of glenoid and humeral component position after total shoulder arthroplasty. J Shoulder Elb Surg 22(10):1413–1422. https://doi.org/10.1016/j.jse.2013.01.005

    Article  Google Scholar 

  13. Kwon YW, Powell KA, Yum JK, Brems JJ, Iannotti JP (2005) Use of three-dimensional computed tomography for the analysis of the glenoid anatomy. J Shoulder Elb Surg 14(1):85–90. https://doi.org/10.1016/j.jse.2004.04.011

    Article  Google Scholar 

  14. Hendel MD, Bryan JA, Barsoum WK, Rodriguez EJ, Brems JJ, Evans PJ, Iannotti JP (2012) Comparison of patient-specific instruments with standard surgical instruments in determining glenoid component position: a randomized prospective clinical trial. J Bone Joint Surg Am 94(23):2167–2175. https://doi.org/10.2106/JBJS.K.01209

    Article  PubMed  Google Scholar 

  15. Molony DC, Cassar Gheiti AJ, Kennedy J, Green C, Schepens A, Mullett HJ (2011) A cadaveric model for suprascapular nerve injury during glenoid component screw insertion in reverse-geometry shoulder arthroplasty. J Shoulder Elb Surg 20(8):1323–1327. https://doi.org/10.1016/j.jse.2011.02.014

    Article  Google Scholar 

  16. Shishido H, Kikuchi S (2001) Injury of the suprascapular nerve in shoulder surgery: an anatomic study. J Shoulder Elb Surg 10(4):372–376. https://doi.org/10.1067/mse.2001.115988

    Article  CAS  Google Scholar 

  17. Chebli C, Huber P, Watling J, Bertelsen A, Bicknell RT, Matsen F 3rd (2008) Factors affecting fixation of the glenoid component of a reverse total shoulder prosthesis. J Shoulder Elb Surg 17(2):323–327. https://doi.org/10.1016/j.jse.2007.07.015

    Article  Google Scholar 

  18. DiStefano JG, Park AY, Nguyen TQ, Diederichs G, Buckley JM, Montgomery WH 3rd (2011) Optimal screw placement for base plate fixation in reverse total shoulder arthroplasty. J Shoulder Elb Surg 20(3):467–476. https://doi.org/10.1016/j.jse.2010.06.001

    Article  Google Scholar 

  19. Humphrey CS, Kelly JD 2nd, Norris TR (2008) Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, part two: the three-column concept. J Shoulder Elb Surg 17(4):595–601. https://doi.org/10.1016/j.jse.2008.05.038

    Article  Google Scholar 

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Correspondence to Xavier Ohl.

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Marcoin, A., Nerot, C., Lestra, T. et al. The precision of patient-specific instrumentation guides for the positioning of the glenoid component in total reverse shoulder arthroplasty: an in vivo scanographic study. International Orthopaedics (SICOT) 44, 1761–1766 (2020). https://doi.org/10.1007/s00264-020-04524-x

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