title: Improved accuracy of K-wire positioning into the glenoid vault by intraoperative 3D image intensifier-based navigation for the glenoid component in shoulder arthroplasty.
abstract: This article aimed to show that navigation, based on an intraoperative mobile 3D image intensifier, can improve the accuracy of central K-wire placement into the glenoid vault for glenoid component.
  
  
  
  The navigated k-wire placement is more accurate and shows a smaller deviation angle to the standard centerline compared to the classical "free hand technic".
  
  
  
  In 34 fresh frozen sheep scapulae, 17 K-wire placements using the navigation (group 1) were compared with 17 using standard "face plane technique" (group 2). The relation to glenoid standard and alternative centerlines (CL) and the position within the glenoid vault were analyzed.
  
  
  
  In groups 1 and 2 the angle between the K-wire and standard CL was 2.2° and 4.7°, respectively (P=0.01). The angle between the K-wire and alternative CL was 14.4° for group 1 and 17.2° for group 2 (P=0.02). More navigated K-wire positions were identified within a 5mm corridor along the glenoid vault CL (52 vs. 39; P=0.004).
  
  
  
  Intraoperative 3D image intensifier-based navigation was more accurate and precise than standard K-wire placement.
  
  
  
  Basic science study, evidence level III.
authors.affiliation: Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany. Electronic address: jan.theopold@medizin.uni-leipzig.de.
authors.forename: J
authors.initials: J
authors.lastname: Theopold
authors.affiliation: Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany; Institute of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 52, 06097 Halle (Saale), Germany. Electronic address: Philipp.Pieroh@medizin.uni-leipzig.de.
authors.forename: P
authors.initials: P
authors.lastname: Pieroh
authors.affiliation: Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany. Electronic address: MariaLuisa.Scharge@medizin.uni-leipzig.de.
authors.forename: M L
authors.initials: ML
authors.lastname: Scharge
authors.affiliation: Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany. Electronic address: Bastian.Marquass@medizin.uni-leipzig.de.
authors.forename: B
authors.initials: B
authors.lastname: Marquaß
authors.affiliation: Institute of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 52, 06097 Halle (Saale), Germany. Electronic address: Tim.Hohmann@medizin.uni-halle.de.
authors.forename: T
authors.initials: T
authors.lastname: Hohmann
authors.affiliation: Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany. Electronic address: Christoph.Josten@medizin.uni-leipzig.de.
authors.forename: C
authors.initials: C
authors.lastname: Josten
authors.affiliation: Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany. Electronic address: Pierre.Hepp@medizin.uni-leipzig.de.
authors.forename: P
authors.initials: P
authors.lastname: Hepp
mesh_terms: D000818:Animals; D001178:Arthroplasty / Q000295:instrumentation / Q000379:methods*; D005260:Female; D061165:Glenoid Cavity / Q000000981:diagnostic imaging / Q000601:surgery*; D021621:Imaging, Three-Dimensional; D011859:Radiography; D012540:Scapula / Q000000981:diagnostic imaging / Q000601:surgery*; D012756:Sheep; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: Computer-assisted surgery; Glenoid centerline; Shoulder arthroplasty