title: Improved accuracy of glenoid positioning in total shoulder arthroplasty with intraoperative navigation: a prospective-randomized clinical study.
abstract: OBJECTIVE
  The correct implantation of the glenoid component is of paramount importance in total shoulder arthroplasty (TSA). We hypothesized that the accuracy of the glenoid positioning in the transverse plane can be improved using intraoperative navigation.
  
  
  METHODS
  This prospective, randomized clinical study comprised 2 groups of 10 patients each with osteoarthritis of the shoulder TSA, with or without intraoperative navigation. Glenoid version was measured on axial computed tomography scans preoperatively and 6 weeks postoperatively.
  
  
  RESULTS
  The operating time was significantly longer in the navigation group (169.5 +/- 15.2 vs 138 +/- 18.4 min). We found an average change of retroversion from 15.4 degrees +/- 5.8 degrees (range, 3.0 degrees -24.0 degrees) preoperatively to 3.7 degrees +/- 6.3 degrees (range, -8.0 degrees to 15.0 degrees) postoperatively in the navigation group compared with 14.4 degrees +/- 6.1 degrees (range, 2.0 degrees -24.0 degrees) preoperatively to 10.9 degrees +/- 6.8 degrees (range, 0.0 degrees -19.0 degrees) postoperatively in the group without navigation (P = .021).
  
  
  CONCLUSIONS
  We found an improved accuracy in glenoid positioning in the transverse plane using intraoperative navigation. The validity of the study is limited by the small number, which advocates continuation with more patients and longer follow-up.
  
  
  METHODS
  Level 2; Therapeutic study.
authors: Shoulder and Elbow Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany. joern.kircher@atos.de
authors: Jörn
authors: J
authors: Kircher
authors: Markus
authors: M
authors: Wiedemann
authors: Petra
authors: P
authors: Magosch
authors: Sven
authors: S
authors: Lichtenberg
authors: Peter
authors: P
authors: Habermeyer
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010003:Osteoarthritis / Q000175:diagnosis / Q000601:surgery*; D011336:Probability; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome