Advertisement

3D preoperative planning for humeral head selection in total shoulder arthroplasty

  • D. J. L. Lima
  • J. Markel
  • J. P. Yawman
  • J. D. Whaley
  • V. J. SabesanEmail author
Original Article

Abstract

Background

Recreation of glenohumeral biomechanics and humeral anatomy has been shown to improve outcomes in shoulder arthroplasty. Recent research has focused on utilizing simulation software and intraoperative instrumentation to improve glenoid implant selection and positioning, but no study had evaluated the reliability of new features in 3D preoperative planning software for humeral planning in total shoulder arthroplasty.

Materials and methods

Preoperative plans were created for 26 patients using three different simulation software programs: an independent preoperative planning simulation (IPPS) software (OrthoVis) and two automated manufacturers preoperative simulation systems: ArthrexVIP™ (AMPS I) and Tornier Blueprint™ 3D Planning (AMPS II). Preoperative plans were compared for reliability and consistency among different software systems based on available variables including humeral head diameter (HD) and head height (HH).

Results

The measured HD was consistent between the three systems with a maximum mean difference of 0.2 mm for HD among IPPS, AMPS I, and AMPS II (p = 0.964). There was a significant difference in measured humeral HH with 1.7 mm difference between IPPS and AMPS II (p ≤ 0.001). The strongest correlation when comparing humeral head measurements (diameter or height) obtained from all systems was seen between IPPS and AMPS I for humeral HD (r = 0.8; p ≤ 0.001).

Conclusion

There was a high level of consistency between independent and manufacturer preoperative planning software for humeral head measurements. These preoperative planning systems can improve efficiency and workflow during surgery by guiding surgeons on implant size selection to optimally reconstruct the glenohumeral kinematics, in order to improve patient outcomes.

Level of evidence

Level III, study of nonconsecutive patients and without a universally applied “gold” standard study of diagnostic test.

Keywords

3D software Humeral head Shoulder arthroplasty templating TSA implant prediction Computer-aided preoperative planning 

Notes

Compliance with ethical standards

Conflict of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards

References

  1. 1.
    Menge TJ, Boykin RE, Byram IR, Bushnell BD (2014) A comprehensive approach to glenohumeral arthritis. South Med J 107(9):567–573.  https://doi.org/10.14423/SMJ.0000000000000166 CrossRefGoogle Scholar
  2. 2.
    Iannotti JP, Greeson C, Downing D, Sabesan V, Bryan JA (2012) Effect of glenoid deformity on glenoid component placement in primary shoulder arthroplasty. J Shoulder Elbow Surg 21(1):48–55.  https://doi.org/10.1016/j.jse.2011.02.011 CrossRefGoogle Scholar
  3. 3.
    Sabesan V, Callanan M, Sharma V, Iannotti JP (2014) Correction of acquired glenoid bone loss in osteoarthritis with a standard versus an augmented glenoid component. J Shoulder Elbow Surg 23(7):964–973.  https://doi.org/10.1016/j.jse.2013.09.019 CrossRefGoogle Scholar
  4. 4.
    Sabesan VJ, Callanan M, Youderian A, Iannotti JP (2014) 3D CT assessment of the relationship between humeral head alignment and glenoid retroversion in glenohumeral osteoarthritis. J Bone Joint Surg Am 96(8):e64.  https://doi.org/10.2106/JBJS.L.00856 CrossRefGoogle Scholar
  5. 5.
    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 CrossRefGoogle Scholar
  6. 6.
    Hoenecke HR Jr, Hermida JC, Flores-Hernandez C, D’Lima DD (2010) Accuracy of CT-based measurements of glenoid version for total shoulder arthroplasty. J Shoulder Elbow Surg 19(2):166–171.  https://doi.org/10.1016/j.jse.2009.08.009 CrossRefGoogle Scholar
  7. 7.
    Iannotti JP, Weiner S, Rodriguez E, Subhas N, Patterson TE, Jun BJ, Ricchetti ET (2015) Three-dimensional imaging and templating improve glenoid implant positioning. J Bone Joint Surg Am 97(8):651–658.  https://doi.org/10.2106/JBJS.N.00493 CrossRefGoogle Scholar
  8. 8.
    Levy JC, Everding NG, Frankle MA, Keppler LJ (2014) Accuracy of patient-specific guided glenoid baseplate positioning for reverse shoulder arthroplasty. J Shoulder Elbow Surg 23(10):1563–1567.  https://doi.org/10.1016/j.jse.2014.01.051 CrossRefGoogle Scholar
  9. 9.
    Lewis GS, Bryce CD, Davison AC, Hollenbeak CS, Piazza SJ, Armstrong AD (2010) Location of the optimized centerline of the glenoid vault: a comparison of two operative techniques with use of three-dimensional computer modeling. J Bone Joint Surg Am 92(5):1188–1194.  https://doi.org/10.2106/JBJS.I.00131 CrossRefGoogle Scholar
  10. 10.
    Sabesan V, Callanan M, Sharma V (2014) Guidelines for the selection of optimal glenoid augment size for moderate to severe glenohumeral osteoarthritis. J Shoulder Elbow Surg 23(7):974–981.  https://doi.org/10.1016/j.jse.2013.09.022 CrossRefGoogle Scholar
  11. 11.
    Franta AK, Lenters TR, Mounce D, Neradilek B, Matsen FA III (2007) The complex characteristics of 282 unsatisfactory shoulder arthroplasties. J Shoulder Elbow Surg 16(5):555–562.  https://doi.org/10.1016/j.jse.2006.11.004 CrossRefGoogle Scholar
  12. 12.
    Hasan SS, Leith JM, Campbell B, Kapil R, Smith KL, Matsen FA III (2002) Characteristics of unsatisfactory shoulder arthroplasties. J Shoulder Elbow Surg 11(5):431–441CrossRefGoogle Scholar
  13. 13.
    Iannotti JP, Spencer EE, Winter U, Deffenbaugh D, Williams G (2005) Prosthetic positioning in total shoulder arthroplasty. J Shoulder Elbow Surg 14(1 Suppl S):111S–121S.  https://doi.org/10.1016/j.jse.2004.09.026 CrossRefGoogle Scholar
  14. 14.
    Verborgt O, De Smedt T, Vanhees M, Clockaerts S, Parizel PM, Van Glabbeek F (2011) Accuracy of placement of the glenoid component in reversed shoulder arthroplasty with and without navigation. J Shoulder Elbow Surg 20(1):21–26.  https://doi.org/10.1016/j.jse.2010.07.014 CrossRefGoogle Scholar
  15. 15.
    von Eisenhart-Rothe R, Muller-Gerbl M, Wiedemann E, Englmeier KH, Graichen H (2008) Functional malcentering of the humeral head and asymmetric long-term stress on the glenoid: potential reasons for glenoid loosening in total shoulder arthroplasty. J Shoulder Elbow Surg 17(5):695–702.  https://doi.org/10.1016/j.jse.2008.02.008 CrossRefGoogle Scholar
  16. 16.
    Gutierrez S, Levy JC, Frankle MA, Cuff D, Keller TS, Pupello DR, Lee WE III (2008) Evaluation of abduction range of motion and avoidance of inferior scapular impingement in a reverse shoulder model. J Shoulder Elbow Surg 17(4):608–615.  https://doi.org/10.1016/j.jse.2007.11.010 CrossRefGoogle Scholar
  17. 17.
    Herrmann S (2016) Shoulder biomechanics. In: Frankle M, Marberry S, Pupello D (eds) Reverse shoulder arthroplasty: biomechanics, clinical techniques, and current technologies. Springer, Cham, pp 21–30.  https://doi.org/10.1007/978-3-319-20840-4_2 CrossRefGoogle Scholar
  18. 18.
    Keener JD, Chalmers PN, Yamaguchi K (2017) The humeral implant in shoulder arthroplasty. J Am Acad Orthop Surg 25(6):427–438.  https://doi.org/10.5435/JAAOS-D-15-00682 CrossRefGoogle Scholar
  19. 19.
    Kircher J, Wiedemann M, Magosch P, Lichtenberg S, Habermeyer P (2009) Improved accuracy of glenoid positioning in total shoulder arthroplasty with intraoperative navigation: a prospective-randomized clinical study. J Shoulder Elbow Surg 18(4):515–520.  https://doi.org/10.1016/j.jse.2009.03.014 CrossRefGoogle Scholar
  20. 20.
    Nguyen D, Ferreira LM, Brownhill JR, King GJ, Drosdowech DS, Faber KJ, Johnson JA (2009) Improved accuracy of computer assisted glenoid implantation in total shoulder arthroplasty: an in-vitro randomized controlled trial. J Shoulder Elbow Surg 18(6):907–914.  https://doi.org/10.1016/j.jse.2009.02.022 CrossRefGoogle Scholar
  21. 21.
    Sabesan VJ, Ackerman J, Sharma V, Baker KC, Kurdziel MD, Wiater JM (2015) Glenohumeral mismatch affects micromotion of cemented glenoid components in total shoulder arthroplasty. J Shoulder Elbow Surg 24(5):814–822.  https://doi.org/10.1016/j.jse.2014.10.004 CrossRefGoogle Scholar
  22. 22.
    Youderian AR, Ricchetti ET, Drews M, Iannotti JP (2014) Determination of humeral head size in anatomic shoulder replacement for glenohumeral osteoarthritis. J Shoulder Elbow Surg 23(7):955–963.  https://doi.org/10.1016/j.jse.2013.09.005 CrossRefGoogle Scholar
  23. 23.
    Savin DD, Piponov H, Goldstein J, Youderian AR (2017) Humeral head sizing using extra-articular landmarks on conventional radiographs. Surg Radiol Anat.  https://doi.org/10.1007/s00276-017-1833-z Google Scholar
  24. 24.
    Lee CS, Davis SM, Lane CJ, Koonce RC, Hartman AP, Ball K, Esch JC (2015) Reliability and accuracy of digital templating for the humeral component of total shoulder arthroplasty. Shoulder Elbow 7(1):29–35.  https://doi.org/10.1177/1758573214550838 CrossRefGoogle Scholar
  25. 25.
    Verborgt O, Vanhees M, Heylen S, Hardy P, Declercq G, Bicknell R (2014) Computer navigation and patient-specific instrumentation in shoulder arthroplasty. Sports Med Arthrosc 22(4):e42–e49.  https://doi.org/10.1097/JSA.0000000000000045 CrossRefGoogle Scholar
  26. 26.
    Parsons IMT, Weldon EJ III, Titelman RM, Smith KL (2004) Glenohumeral arthritis and its management. Phys Med Rehabil Clin N Am 15(2):447–474.  https://doi.org/10.1016/j.pmr.2003.12.001 CrossRefGoogle Scholar
  27. 27.
    Bellanova L, Paul L, Docquier PL (2013) Surgical guides (patient-specific instruments) for pediatric tibial bone sarcoma resection and allograft reconstruction. Sarcoma 2013:787653.  https://doi.org/10.1155/2013/787653 CrossRefGoogle Scholar
  28. 28.
    Dai KR, Yan MN, Zhu ZA, Sun YH (2007) Computer-aided custom-made hemipelvic prosthesis used in extensive pelvic lesions. J Arthroplasty 22(7):981–986.  https://doi.org/10.1016/j.arth.2007.05.002 CrossRefGoogle Scholar
  29. 29.
    Deshmukh TR, Kuthe AM, Vaibhav B (2010) Preplanning and simulation of surgery using rapid modelling. J Med Eng Technol 34(4):291–294.  https://doi.org/10.3109/03091901003753058 CrossRefGoogle Scholar
  30. 30.
    Guarino J, Tennyson S, McCain G, Bond L, Shea K, King H (2007) Rapid prototyping technology for surgeries of the pediatric spine and pelvis: benefits analysis. J Pediatr Orthop 27(8):955–960.  https://doi.org/10.1097/bpo.0b013e3181594ced CrossRefGoogle Scholar
  31. 31.
    Hananouchi T, Saito M, Koyama T, Hagio K, Murase T, Sugano N, Yoshikawa H (2009) Tailor-made surgical guide based on rapid prototyping technique for cup insertion in total hip arthroplasty. Int J Med Robot 5(2):164–169.  https://doi.org/10.1002/rcs.243 CrossRefGoogle Scholar
  32. 32.
    Izatt MT, Thorpe PL, Thompson RG, D’Urso PS, Adam CJ, Earwaker JW, Labrom RD, Askin GN (2007) The use of physical biomodelling in complex spinal surgery. Eur Spine J 16(9):1507–1518.  https://doi.org/10.1007/s00586-006-0289-3 CrossRefGoogle Scholar
  33. 33.
    Martelli N, Serrano C, van den Brink H, Pineau J, Prognon P, Borget I, El Batti S (2016) Advantages and disadvantages of 3-dimensional printing in surgery: a systematic review. Surgery 159(6):1485–1500.  https://doi.org/10.1016/j.surg.2015.12.017 CrossRefGoogle Scholar
  34. 34.
    Yamazaki M, Akazawa T, Okawa A, Koda M (2007) Usefulness of three-dimensional full-scale modeling of surgery for a giant cell tumor of the cervical spine. Spinal Cord 45(3):250–253.  https://doi.org/10.1038/sj.sc.3101959 CrossRefGoogle Scholar
  35. 35.
    Yang JC, Ma XY, Lin J, Wu ZH, Zhang K, Yin QS (2011) Personalised modified osteotomy using computer-aided design-rapid prototyping to correct thoracic deformities. Int Orthop 35(12):1827–1832.  https://doi.org/10.1007/s00264-010-1155-9 CrossRefGoogle Scholar
  36. 36.
    Yang M, Li C, Li Y, Zhao Y, Wei X, Zhang G, Fan J, Ni H, Chen Z, Bai Y, Li M (2015) Application of 3D rapid prototyping technology in posterior corrective surgery for Lenke 1 adolescent idiopathic scoliosis patients. Medicine 94(8):e582.  https://doi.org/10.1097/MD.0000000000000582 CrossRefGoogle Scholar
  37. 37.
    Zhang YZ, Chen B, Lu S, Yang Y, Zhao JM, Liu R, Li YB, Pei GX (2011) Preliminary application of computer-assisted patient-specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip. Int J Med Robot 7(4):469–474.  https://doi.org/10.1002/rcs.423 CrossRefGoogle Scholar

Copyright information

© Istituto Ortopedico Rizzoli 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryCleveland Clinic FloridaWestonUSA
  2. 2.Department of Orthopaedic SurgeryWayne State University School of MedicineTaylorUSA
  3. 3.Florida Atlantic University Charles E. Schmidt College of MedicineBoca RatonUSA
  4. 4.Department of Orthopedic SurgeryBeaumont Health SystemRoyal OakUSA

Personalised recommendations