Introduction Three-dimensional (3D) preoperative planning and patient-specific instrumentation (PSI) improve accuracy of glenoid component implantation in reverse shoulder arthroplasty.
Indications & Contraindications
Step 1: Preoperative Virtual 3D Planning (Video 1) Use a 3D software tool for virtual preoperative planning of glenoid component implantation.
Step 2: Patient Positioning and Surgical Approach (Video 2) Place the patient in a semi-beach-chair position and perform a standard deltopectoral approach.
Step 3: Humeral Preparation (Video 3) Prepare the humeral side for implantation of the humeral component using standard instrumentation.
Step 4: Glenoid Exposure and Preparation (Video 4) Expose the glenoid and prepare the glenoid surface for component implantation.
Step 5: Glenoid Preparation and Implantation of the Glenoid Baseplate Using 4 PSI Guides (Video 5) Use the 4 PSI guides to prepare the glenoid for component implantation according to the preoperative plan.
Step 6: Definitive Implantation of the Components and Reduction (Video 6) Implant the glenosphere and humeral component and reduce the prosthesis.
Step 7: Postoperative Rehabilitation Protocol Start passive and active-assisted exercises immediately, and begin muscle strengthening and active exercises at 6 weeks.
Results A recent prospective, comparative study assessed the influence of 3D preoperative planning and PSI guidance of glenoid component positioning in total shoulder arthroplasty and reverse shoulder arthroplasty18.
Pitfalls & Challenges
Three-dimensional (3D) preoperative planning and patient-specific instrumentation (PSI) improve accuracy of glenoid component implantation in reverse shoulder arthroplasty.
Reverse arthroplasty has been proven to be a successful treatment for end-stage cuff tear arthropathy in elderly patients1-6. However, correct positioning and fixation of the glenoid component remain one of the most important challenges of the procedure that will determine early and long-term results2,7-9. Variable glenoid vault anatomy and bone stock may compromise the ultimate …
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