Advertisement

International Orthopaedics

, Volume 42, Issue 12, pp 2897–2906 | Cite as

Proper benefit of a three dimensional pre-operative planning software for glenoid component positioning in total shoulder arthroplasty

  • Adrien Jacquot
  • Marc-Olivier Gauci
  • Jean Chaoui
  • Mohammed Baba
  • Pierric Deransart
  • Pascal Boileau
  • Daniel Mole
  • Gilles Walch
Original Paper
  • 100 Downloads

Abstract

Purpose

Glenoid loosening after total shoulder arthroplasty (TSA) is influenced by the position of the glenoid component. 3D planning software and patient-specific guides seem to improve positioning accuracy, but their respective individual application and role are yet to be defined. The aim of this study was to evaluate the accuracy of freehand implantation after 3D pre-operative planning and to compare its accuracy to that of a targeting guide.

Method

Seventeen patients scheduled for TSA for primary glenohumeral arthritis were enrolled in this prospective study. Every patient had pre-operative planning, based on a CT scan. Glenoid component implantation was performed freehand, guided by 3D views displayed in the operating room. The position of the glenoid component was determined by manual segmentation of post-operative CT scans and compared to the planned position. The results were compared to those obtained in a previous work with the use of a patient-specific guide.

Results

The mean error for the central point was 2.89 mm (SD ± 1.36) with the freehand method versus 2.1 mm (SD ± 0.86) with use of a targeting guide (p = 0.05). The observed difference was more significant (p = 0.03) for more severely retroverted glenoids (> 10°). The mean errors for version and inclination were respectively 4.82° (SD ± 3.12) and 4.2° (SD ± 2.14) with freehand method, compared to 4.87° (SD ± 3.61) and 4.39° (SD ± 3.36) with a targeting guide (p = 0.97 and 0.85, respectively).

Conclusion

3D pre-operative planning allowed accurate glenoid component positioning with a freehand method. Compared to the freehand method, patient-specific guides slightly improved the position of the central point, especially for severely retroverted glenoids, but not the orientation of the component.

Keywords

Patient-specific guides 3D planning Total shoulder arthroplasty Positioning Accuracy Glenoid component 

Notes

Compliance with ethical standards

Conflict of interest

Dr. Adrien Jacquot is a consultant for Tornier-Wright Medical and for Smith and Nephew Company.

M. Jean Chaoui is an employee of Imascap and owns stock equity in Imascap.

M. Pierric Deransart is an employee of Imascap.

Pr. Daniel Mole receives royalties from Tornier-Wright Medical and is a consultant for Tornier-Wright Medical.

Pr. Pascal Boileau and Dr. Gilles Walch receive royalties from Tornier/Wright Company and equity from Imascap.

Dr. Marc-Olivier Gauci and Dr. Mohammed Baba have no conflict of interest.

Disclaimer

None

Ethics approval

The Institutional Review Board of the ethical committee of the Hôpital Privé Jean Mermoz and the Centre Orthopédique Santy approved this project (Study 20.1611).

Supplementary material

264_2018_4037_MOESM1_ESM.xlsx (31 kb)
ESM 1 (XLSX 31 kb)

References

  1. 1.
    Carter MJ, Mikuls TR, Nayak S et al (2012) Impact of total shoulder arthroplasty on generic and shoulder-specific health-related quality-of-life measures: a systematic literature review and meta-analysis. J Bone Joint Surg Am 94:e127.  https://doi.org/10.2106/JBJS.K.00204 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Walch G, Young AA, Melis B et al (2011) Results of a convex-back cemented keeled glenoid component in primary osteoarthritis: multicenter study with a follow-up greater than 5 years. J Shoulder Elb Surg 20:385–394.  https://doi.org/10.1016/j.jse.2010.07.011 CrossRefGoogle Scholar
  3. 3.
    Torchia ME, Cofield RH, Settergren CR (1997) Total shoulder arthroplasty with the Neer prosthesis: long-term results. J Shoulder Elb Surg 6:495–505.  https://doi.org/10.1016/S1058-2746(97)90081-1 CrossRefGoogle Scholar
  4. 4.
    Walch G, Young AA, Boileau P et al (2012) Patterns of loosening of polyethylene keeled glenoid components after shoulder arthroplasty for primary osteoarthritis: results of a multicenter study with more than five years of follow-up. J Bone Jt Surg Am 94.  https://doi.org/10.2106/JBJS.J.00699
  5. 5.
    Farron A, Terrier A, Büchler P (2006) Risks of loosening of a prosthetic glenoid implanted in retroversion. J Shoulder Elb Surg 15:521–526.  https://doi.org/10.1016/j.jse.2005.10.003 CrossRefGoogle Scholar
  6. 6.
    Hopkins AR, Hansen UN, Amis AA, Emery R (2004) The effects of glenoid component alignment variations on cement mantle stresses in total shoulder arthroplasty. J Shoulder Elb Surg 13:668–675.  https://doi.org/10.1016/j.jse.2004.04.008 CrossRefGoogle Scholar
  7. 7.
    Iannotti JP, Spencer EE, Winter U et al (2005) Prosthetic positioning in total shoulder arthroplasty. J Shoulder Elb Surg Am Shoulder Elb Surg Al 14:111S–121S.  https://doi.org/10.1016/j.jse.2004.09.026 CrossRefGoogle Scholar
  8. 8.
    Nyffeler RW, Sheikh R, Atkinson TS et al (2006) Effects of glenoid component version on humeral head displacement and joint reaction forces: an experimental study. J Shoulder Elb Surg Am Shoulder Elb Surg Al 15:625–629.  https://doi.org/10.1016/j.jse.2005.09.016 CrossRefGoogle Scholar
  9. 9.
    Shapiro TA, McGarry MH, Gupta R et al (2007) Biomechanical effects of glenoid retroversion in total shoulder arthroplasty. J Shoulder Elb Surg 16:S90–S95.  https://doi.org/10.1016/j.jse.2006.07.010 CrossRefGoogle Scholar
  10. 10.
    Hendel MD, Bryan JA, Barsoum WK et al (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 94:2167–2175.  https://doi.org/10.2106/JBJS.K.01209 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Iannotti J, Baker J, Rodriguez E et al (2014) Three-dimensional preoperative planning software and a novel information transfer technology improve glenoid component positioning. J Bone Joint Surg Am 96:e71.  https://doi.org/10.2106/JBJS.L.01346 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Iannotti JP, Greeson C, Downing D et al (2012) Effect of glenoid deformity on glenoid component placement in primary shoulder arthroplasty. J Shoulder Elb Surg Am Shoulder Elb Surg Al 21:48–55.  https://doi.org/10.1016/j.jse.2011.02.011 CrossRefGoogle Scholar
  13. 13.
    Lewis GS, Stevens NM, Armstrong AD (2015) Testing of a novel pin array guide for accurate three-dimensional glenoid component positioning. J Shoulder Elb Surg Am Shoulder Elb Surg Al 24:1939–1947.  https://doi.org/10.1016/j.jse.2015.06.022 CrossRefGoogle Scholar
  14. 14.
    Nguyen D, Ferreira LM, Brownhill JR et al (2009) Improved accuracy of computer assisted glenoid implantation in total shoulder arthroplasty: an in-vitro randomized controlled trial. J Shoulder Elb Surg Am Shoulder Elb Surg Al 18:907–914.  https://doi.org/10.1016/j.jse.2009.02.022 CrossRefGoogle Scholar
  15. 15.
    Throckmorton TW, Gulotta LV, Bonnarens FO et al (2015) Patient-specific targeting guides compared with traditional instrumentation for glenoid component placement in shoulder arthroplasty: a multi-surgeon study in 70 arthritic cadaver specimens. J Shoulder Elb Surg Am Shoulder Elb Surg Al 24:965–971.  https://doi.org/10.1016/j.jse.2014.10.013 CrossRefGoogle Scholar
  16. 16.
    Walch G, Vezeridis PS, Boileau P et al (2015) Three-dimensional planning and use of patient-specific guides improve glenoid component position: an in vitro study. J Shoulder Elb Surg Am Shoulder Elb Surg Al 24:302–309.  https://doi.org/10.1016/j.jse.2014.05.029 CrossRefGoogle Scholar
  17. 17.
    Gauci MO, Boileau P, Baba M et al (2016) Patient-specific glenoid guides provide accuracy and reproducibility in total shoulder arthroplasty. Bone Jt J 98-B:1080–1085.  https://doi.org/10.1302/0301-620X.98B8.37257 CrossRefGoogle Scholar
  18. 18.
    Iannotti JP, Weiner S, Rodriguez E et al (2015) Three-dimensional imaging and templating improve glenoid implant positioning. J Bone Joint Surg Am 97:651–658.  https://doi.org/10.2106/JBJS.N.00493 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Suero EM, Citak M, Lo D et al (2013) Use of a custom alignment guide to improve glenoid component position in total shoulder arthroplasty. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 21:2860–2866.  https://doi.org/10.1007/s00167-012-2177-1 CrossRefGoogle Scholar
  20. 20.
    Chaoui J, Hamitouche C, Stindel E, Roux C (2011) Recognition-based segmentation and registration method for image guided shoulder surgery. Conf Proc Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf 2011:6212–6215.  https://doi.org/10.1109/IEMBS.2011.6091534 CrossRefGoogle Scholar
  21. 21.
    Moineau G, Levigne C, Boileau P et al (2012) Three-dimensional measurement method of arthritic glenoid cavity morphology: feasibility and reproducibility. Orthop Traumatol Surg Res OTSR 98:S139–S145.  https://doi.org/10.1016/j.otsr.2012.06.007 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast 14:756–760CrossRefGoogle Scholar
  23. 23.
    Molé D, Roche O, Riand N, et al (1999) Cemented glenoid component: results in osteoarthritis and rheumatoid arthritis. In: Walch G, Boileau P (eds) Shoulder arthroplasty. Springer, Berlin, Heidelberg, pp 163–171Google Scholar
  24. 24.
    Jain N, Pietrobon R, Hocker S et al (2004) The relationship between surgeon and hospital volume and outcomes for shoulder arthroplasty. J Bone Joint Surg Am 86-A:496–505CrossRefPubMedCentralGoogle Scholar
  25. 25.
    Singh A, Yian EH, Dillon MT et al (2014) The effect of surgeon and hospital volume on shoulder arthroplasty perioperative quality metrics. J Shoulder Elb Surg Am Shoulder Elb Surg Al 23:1187–1194.  https://doi.org/10.1016/j.jse.2013.11.017 CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.SAS Clinique Louis PasteuEssey-lès-NancyFrance
  2. 2.Chirurgie des Articulations et du SportCentre ARTICSNancyFrance
  3. 3.Institut Universitaire Locomoteur et du SportNiceFrance
  4. 4.Société IMASCAPPlouzanéFrance
  5. 5.Institut Mine Telecom AtlantiquePlouzanéFrance
  6. 6.Sydney Adventist HospitalWahroongaAustralia
  7. 7.Centre Orthopédique SantyLyonFrance

Personalised recommendations