title: Distribution of Glenoid Implant Options for Correcting Deformities Using a Preoperative Planning Tool.
abstract: Preoperative planning tools in shoulder arthroplasty are a recently developing technology with the advantage of being able to clearly assess patient anatomy and deformities before entering the OR. Addressing retroverted glenoids remains one of the most difficult aspects of primary shoulder arthroplasty. In this study, five surgeons were provided with a preoperative planning tool with posterior augmented glenoid implant options (0°, 8°, and 16°) to treat 10 cadaveric cases with a range of versions from 7.8° anteversion to 25.1° retroversion. Surgeons were able to remove less bone using 8° augmented implants over standard non-augmented implants (2.8° reamed vs. 6.4° reamed) and were able to correct each case on average within ± 1.8° of neutral version. Slight glenoid vault perforation was observed in 18% of the plans. Eight degrees posterior augmented implants were used in scans averaging 9.0° retroversion, and 16° posterior augmented implants were used in scans averaging 20.6° retroversion. Results were then compared to 14 preoperative CT scans provided by one of the surgeons in which both 8° and 16° posterior augmented glenoid implants were used in actual patients, showing 8° posterior augmented implants were used in cases averaging 12.3° retroversion, and 16° posterior augmented implants were used in cases averaging 20.7° retroversion. The study shows that surgeons can effectively and predictably use a preoperative planning tool to correct glenoid abnormalities using augmented implant solutions while minimizing both scapular bone removal and vault perforation and maximizing version correction.
authors.forename: Alexander
authors.initials: A
authors.lastname: Greene
authors.forename: Richard B
authors.initials: RB
authors.lastname: Jones
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Wright
authors.forename: Ira M
authors.initials: IM
authors.lastname: Parsons
authors.forename: Paul
authors.initials: P
authors.lastname: Saadi
authors.forename: Emilie V
authors.initials: EV
authors.lastname: Cheung
authors.forename: Sandrine
authors.initials: S
authors.lastname: Polakovic
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Hamilton
mesh_terms: D019643:Arthroplasty, Replacement / Q000295:instrumentation*; D003198:Computer Simulation; D061165:Glenoid Cavity / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007595:Joint Prosthesis; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D020127:Recovery of Function; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome