Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trial
Hypothesis: Glenoid baseplate positioning for reverse total shoulder arthroplasty (rTSA) is important for stability and longevity, with techniques such as image-derived instrumentation (IDI) developed for improving implant placement accuracy. We performed a single-blinded randomized controlled trial...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323000701 |
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| author | Pamela Boekel, MBBS (Hons), MSc Matthew Rikard-Bell, MBBS Andrea Grant, BSpExSci Benjamin Brandon, MBBS Kenji Doma, PhD William B. O’Callaghan, MBBS Matthew Wilkinson, MBBS Levi Morse, BMBS (Hons) |
| author_facet | Pamela Boekel, MBBS (Hons), MSc Matthew Rikard-Bell, MBBS Andrea Grant, BSpExSci Benjamin Brandon, MBBS Kenji Doma, PhD William B. O’Callaghan, MBBS Matthew Wilkinson, MBBS Levi Morse, BMBS (Hons) |
| author_sort | Pamela Boekel, MBBS (Hons), MSc |
| collection | DOAJ |
| description | Hypothesis: Glenoid baseplate positioning for reverse total shoulder arthroplasty (rTSA) is important for stability and longevity, with techniques such as image-derived instrumentation (IDI) developed for improving implant placement accuracy. We performed a single-blinded randomized controlled trial comparing glenoid baseplate insertion accuracy with 3D preoperative planning and IDI jigs vs. 3D preoperative planning and conventional instrumentation. Methods: All patients had a preoperative 3D computed tomography to create an IDI; then underwent rTSA according to their randomized method. Repeat computed tomography scans performed at six weeks postoperatively were compared to the preoperative plan to assess for accuracy of implantation. Patient-reported outcome measures and plain radiographs were collected with 2-year follow-up. Results: Forty-seven rTSA patients were included (IDI n = 24, conventional instrumentation n = 23). The IDI group was more likely to have a guidewire placement within 2mm of the preoperative plan in the superior/inferior plane (P = .01); and exhibited a smaller degree of error when the native glenoid retroversion was >10° (P = .047). There was no difference in patient-reported outcome measures or other radiographic parameters between the two groups. Conclusion: IDI is an accurate method for glenoid guidewire and component placement in rTSA, particularly in the superior/inferior plane and in glenoids with native retroversion >10°, when compared to conventional instrumentation. |
| first_indexed | 2024-03-13T03:28:27Z |
| format | Article |
| id | doaj.art-848f3de7a1d7423d85c3e6faf520fdf5 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-03-13T03:28:27Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-848f3de7a1d7423d85c3e6faf520fdf52023-06-25T04:43:57ZengElsevierJSES International2666-63832023-07-0174614622Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trialPamela Boekel, MBBS (Hons), MSc0Matthew Rikard-Bell, MBBS1Andrea Grant, BSpExSci2Benjamin Brandon, MBBS3Kenji Doma, PhD4William B. O’Callaghan, MBBS5Matthew Wilkinson, MBBS6Levi Morse, BMBS (Hons)7Orthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia; Department of Orthopaedic Surgery, Townsville University Hospital, James Cook University, Townsville, Queensland, Australia; Corresponding author: Pamela Boekel, MBBS (Hons), MSc, FRACS (Orth), Orthopaedic Research Institute of Queensland, 7 Turner Street, Pimlico, Queensland, Australia 4812.Orthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia; Department of Orthopaedic Surgery, Townsville University Hospital, James Cook University, Townsville, Queensland, AustraliaOrthopaedic Research Institute of Queensland, Pimlico, Queensland, AustraliaOrthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia; Department of Orthopaedic Surgery, Townsville University Hospital, James Cook University, Townsville, Queensland, AustraliaOrthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia; Department of Sports and Exercise Science, James Cook University, Townsville, Queensland, AustraliaOrthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia; Department of Orthopaedic Surgery, Cairns Hospital, Cairns, Queensland, AustraliaOrthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia; Department of Orthopaedic Surgery, Royal Hobart Hospital and Calvary Care, University of Tasmania, Hobart, Tasmania, AustraliaOrthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia; Department of Orthopaedic Surgery, Townsville University Hospital, James Cook University, Townsville, Queensland, AustraliaHypothesis: Glenoid baseplate positioning for reverse total shoulder arthroplasty (rTSA) is important for stability and longevity, with techniques such as image-derived instrumentation (IDI) developed for improving implant placement accuracy. We performed a single-blinded randomized controlled trial comparing glenoid baseplate insertion accuracy with 3D preoperative planning and IDI jigs vs. 3D preoperative planning and conventional instrumentation. Methods: All patients had a preoperative 3D computed tomography to create an IDI; then underwent rTSA according to their randomized method. Repeat computed tomography scans performed at six weeks postoperatively were compared to the preoperative plan to assess for accuracy of implantation. Patient-reported outcome measures and plain radiographs were collected with 2-year follow-up. Results: Forty-seven rTSA patients were included (IDI n = 24, conventional instrumentation n = 23). The IDI group was more likely to have a guidewire placement within 2mm of the preoperative plan in the superior/inferior plane (P = .01); and exhibited a smaller degree of error when the native glenoid retroversion was >10° (P = .047). There was no difference in patient-reported outcome measures or other radiographic parameters between the two groups. Conclusion: IDI is an accurate method for glenoid guidewire and component placement in rTSA, particularly in the superior/inferior plane and in glenoids with native retroversion >10°, when compared to conventional instrumentation.http://www.sciencedirect.com/science/article/pii/S2666638323000701Image-derived instrumentationReverse total shoulder arthroplasty3D preoperative planningOrthopedic surgeryArthroplastyPatient-specific instrumentation |
| spellingShingle | Pamela Boekel, MBBS (Hons), MSc Matthew Rikard-Bell, MBBS Andrea Grant, BSpExSci Benjamin Brandon, MBBS Kenji Doma, PhD William B. O’Callaghan, MBBS Matthew Wilkinson, MBBS Levi Morse, BMBS (Hons) Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trial JSES International Image-derived instrumentation Reverse total shoulder arthroplasty 3D preoperative planning Orthopedic surgery Arthroplasty Patient-specific instrumentation |
| title | Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trial |
| title_full | Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trial |
| title_fullStr | Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trial |
| title_full_unstemmed | Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trial |
| title_short | Image-derived instrumentation vs. conventional instrumentation with 3D planning for glenoid component placement in reverse total shoulder replacements: a randomized controlled trial |
| title_sort | image derived instrumentation vs conventional instrumentation with 3d planning for glenoid component placement in reverse total shoulder replacements a randomized controlled trial |
| topic | Image-derived instrumentation Reverse total shoulder arthroplasty 3D preoperative planning Orthopedic surgery Arthroplasty Patient-specific instrumentation |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323000701 |
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