Improved accuracy of glenoid positioning in total shoulder arthroplasty with intraoperative navigation: a prospective-randomized clinical study.
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.
Kircher
Jörn
J
Shoulder and Elbow Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany. joern.kircher@atos.de
Wiedemann
Markus
M
Magosch
Petra
P
Lichtenberg
Sven
S
Habermeyer
Peter
P
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