Kircher Jörn, Wiedemann Markus, Magosch Petra, Lichtenberg Sven, Habermeyer Peter
Shoulder and Elbow Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany.
J Shoulder Elbow Surg. 2009 Jul-Aug;18(4):515-20. doi: 10.1016/j.jse.2009.03.014.
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.
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.
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).
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.
Level 2; Therapeutic study.
在全肩关节置换术（TSA）中，关节盂假体的正确植入至关重要。我们假设术中导航可提高关节盂在横平面定位的准确性。
这项前瞻性随机临床研究包括两组，每组10例患有肩部骨关节炎的TSA患者，分别采用术中导航和不采用术中导航。术前和术后6周通过轴向计算机断层扫描测量关节盂角度。
导航组的手术时间明显更长（169.5±15.2分钟对138±18.4分钟）。我们发现导航组术前平均后倾角度为15.4°±5.8°（范围3.0°-24.0°），术后为3.7°±6.3°（范围-8.0°至15.0°）；相比之下，非导航组术前平均后倾角度为14.4°±6.1°（范围2.0°-24.0°），术后为10.9°±6.8°（范围0.0°-19.0°）（P = 0.021）。
我们发现术中导航可提高关节盂在横平面定位的准确性。本研究的有效性受样本量小的限制，建议纳入更多患者并进行更长时间的随访。
2级；治疗性研究。
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