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Difference analysis of the glenoid centerline between 3D preoperative planning and 3D printed prosthesis manipulation in total shoulder arthroplasty

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Excessive version and inclination of the glenoid component during total shoulder arthroplasty can lead to glenohumeral instability, early loosening, and even failure. The orientation and position of the central pin determine the version and inclination of the glenoid component. The purpose of this study was to compare the differences in centerline position and orientation obtained using "3D preoperative planning based on the best-fit method for glenoid elements" and the surgeon's manipulation.

Materials and methods

Twenty-nine CT images of glenohumeral osteoarthritis of the shoulder were reconstructed into a 3D model, and a 3D printer was used to create an in vitro model for the surgeon to drill the center pin. The 3D shoulder model was also used for 3D preoperative planning (3DPP) using the best-fit method for glenoid elements. The in vitro model was scanned and the version, inclination and center position were measured to compare with the 3DPP results.

Results

The respective mean inclinations (versions) of the surgeon and 3DPP were −2.63° ± 6.60 (2.87° ± 5.97) and −1.96° ± 4.24 (−3.21° ± 4.00), respectively. There was no significant difference in the inclination and version of the surgeon and 3DPP. For surgeons, the probability of the inclination and version being greater than 10° was 13.8% (4/29) and 10.3% (3/29), respectively. Compared to the 3DPP results, the surgeon's center position was shifted down an average of 1.63 mm. There was a significant difference in the center position of the surgeon and 3DPP (p < 0.05).

Conclusion

The central pin drilled by surgeons using general instruments was significantly lower than those defined using 3D preoperative planning and standard central definitions. 3D preoperative planning prevents the version and inclination of the centerline from exceeding safe values (± 10°).

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Data availability

The data that support the findings of this study are openly available in [Seminars in Arthroplasty] at https://doi.org/10.1053/j.sart.2017.05.005, reference number [Volume 28, Issue 1, March 2017, Pages 25–29].

Abbreviations

3DPP:

3D preoperative planning

PSI:

Patient-specific instrumentation

CAD:

Computer-aided design

MCL:

Manual centerline

SCL:

Standard centerline

ACL:

Alternate centerline

BCL:

The centerline of the best-fit implant

ABS:

Acrylonitrile butadiene styrene

ICP:

Iterative closest point algorithm

GC:

The center of the glenoid surface

E CP_dis :

The distance between the center position and the GC

Max. + Y :

The maximum center positions of each centerline in the superior direction

Max. −Y :

The maximum center positions of each centerline in the inferior direction

Max. + Z :

The maximum center positions of each centerline in the anterior direction

Max.−Z :

The maximum center positions of each centerline in the posterior direction

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Acknowledgements

The authors thank Chang Gung Memorial Hospital (GMRPG3H1741) for funding this study and Horng Bang International Co., Ltd, Taiwan, providing 3D scanning device and technology.

Funding

This project was supported by cooperative research from Chang Gung Memorial Hospital (GMRPG3H1741). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the donor.

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Author notes

  1. Chi-Pin Hsu and Chen-Te Wu contributed equally to this work.

Authors and Affiliations

  1. High Speed 3D Printing Research Center, National Taiwan University of Science and Technology, Taipei, Taiwan

    Chi-Pin Hsu

  2. Department of Orthopaedic Surgery Division of Sports Medicine and Musculoskeletal Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan

    Chao-Yu Chen & Kuo-Yao Hsu

  3. Department of Medical Imaging and Intervention Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Chen-Te Wu

  4. Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan

    Shang-Chih Lin

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Correspondence to Chao-Yu Chen or Kuo-Yao Hsu.

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The authors Chi-Pin Hsu, Chen-Te Wu, Chao-Yu Chen, Shang-Chih Lin,and Kuo-Yao Hsu, their immediate families and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity that are related to the subject of this article.

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This study was granted an exemption by the Chang Gung Memorial Hospital Institutional Review Board (Protocol No. 201701867B0C501).

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Hsu, CP., Wu, CT., Chen, CY. et al. Difference analysis of the glenoid centerline between 3D preoperative planning and 3D printed prosthesis manipulation in total shoulder arthroplasty. Arch Orthop Trauma Surg 143, 4065–4075 (2023). https://doi.org/10.1007/s00402-022-04688-8

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