Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 E 70th St., New York, NY, 10021, USA,
Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2860-6. doi: 10.1007/s00167-012-2177-1. Epub 2012 Aug 30.
Total and reverse total shoulder arthroplasty (TSA) are used to treat patients with glenohumeral joint osteoarthritis. The revision rate remains high compared with hip and knee arthroplasty. Glenoid component loosening is an important complication and may be caused by poor positioning of the component. We aimed to evaluate the safety and accuracy of a custom glenoid jig created using preoperative computed tomography (CT) imaging with 3D modelling for glenoid component implantation.
Preoperative CT scans of each shoulder (N = 7) were obtained. Implants were virtually aligned and custom templates were created for intraoperative use. A two-part custom jig was manufactured for alignment of the central peg and the peripheral screws. Three-dimensional orientation of the component and screws was evaluated in postoperative CT scans. The difference between the preoperative plan and the result was then calculated.
No technical difficulties or complications occurred. The mean absolute difference between the planned alignment and the postoperative placement of the glenoid component in the three-dimensional space was 3.4 mm (SD = 1 mm). The total average difference for all screws (N = 10) was 6.3° (SD = 3.2°).
A CT-based custom glenoid component alignment can reliably guide the placement of the glenoid component during conventional and reverse TSA. This custom jig may be useful for optimizing glenoid component position in the setting of reverse and TSA.
全肩关节和反式全肩关节置换术（TSA）用于治疗肩关节骨关节炎患者。与髋关节和膝关节置换术相比，其翻修率仍然较高。肩胛盂组件松动是一种重要的并发症，可能是由于组件位置不良引起的。我们旨在评估使用术前 CT（计算机断层扫描）成像和 3D 建模创建的定制肩胛盂夹具进行肩胛盂组件植入的安全性和准确性。
对每个肩部（N=7）进行术前 CT 扫描。虚拟对齐植入物，并为术中使用创建定制模板。制造了两部分定制夹具，用于对准中央销钉和外围螺钉。在术后 CT 扫描中评估组件和螺钉的三维方向。然后计算术前计划与结果之间的差异。
未发生技术困难或并发症。在三维空间中，肩胛盂组件的规划对准与术后放置之间的平均绝对差异为 3.4 毫米（SD=1 毫米）。所有螺钉（N=10）的总平均差异为 6.3°（SD=3.2°）。
基于 CT 的定制肩胛盂组件对准可可靠地指导常规和反式 TSA 中肩胛盂组件的放置。该定制夹具可用于优化反式和 TSA 中肩胛盂组件的位置。
