Array.
Università di Siena.
Acta Biomed. 2020 May 30;91(4-S):204-208. doi: 10.23750/abm.v91i4-S.9377.
The reverse shoulder arthroplasty (RSA) has risen exponentially, this has entailed an increasing number of complications and reoperations. In RSA, loads are transferred directly to the glenoid component. As a result, failure of the glenoid component is one of the most common complications. CT 3D preoperative planning, patient-specific and the possibility of performing a more precise and controlled surgical gesture in the operating room are increasingly important. The use of the GPS navigation on CT 3D planning has proved to be useful above all in terms of accuracy, reliability and the possibility of reproducing the planned gesture preoperatively.
This study analyzes the precision, safety, and reproducibility of the GPS system for the reverse shoulder prosthesis tested on 6 scapulohumeral cadaver specimens, subsequently subjected to anatomical dissection to verify the correct positioning of the glenoidcomponents and the percentage of appropriateness in the field of planning previously virtually assumed.
Postoperative macroscopic dissection revealed no central peg perforated or screws malpositioned, no leaking from the bone or injury to the adjacent neurovascular structures. The average length of the screws was 42 mm (range 36 mm to 46 mm) for the lower screw and 40 mm for the upper one (range 36 mm to 42 mm).
This cadaver study has shown that GPS navigation offers greater efficiency in baseplate and screws placement and can avoid intra- and postoperative complications.
反肩置换术(RSA)的应用呈指数级增长,这导致了并发症和再次手术的数量不断增加。在 RSA 中,负载直接转移到肩胛盂组件上。因此,肩胛盂组件的失效是最常见的并发症之一。术前 CT 三维规划、个体化和在手术室中进行更精确和可控手术的可能性变得越来越重要。GPS 导航在 CT 三维规划中的应用已被证明在准确性、可靠性和术前重现规划手术的可能性方面非常有用。
本研究分析了 GPS 系统在 6 个肩胛肱骨头尸体标本上测试的反向肩假体的精度、安全性和可重复性,随后进行解剖学解剖以验证肩胛盂组件的正确定位以及术前虚拟假定的规划区域的适当性百分比。
术后宏观解剖显示无中心销穿孔或螺钉位置不当,无骨漏或邻近神经血管结构损伤。下螺钉的平均长度为 42 毫米(范围 36 毫米至 46 毫米),上螺钉为 40 毫米(范围 36 毫米至 42 毫米)。
这项尸体研究表明,GPS 导航在肩胛盂假体和螺钉的放置方面具有更高的效率,并可以避免术中及术后并发症。