Yoon Jong Pil, Kim Dong Hyun, Jung Jae Wook, Lee Chang-Hwa, Min Seunggi, Lee Hyun Joo, Kim Hee-June
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
Clin Shoulder Elb. 2019 Mar 1;22(1):16-23. doi: 10.5397/cise.2019.22.1.16. eCollection 2019 Mar.
We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components.
20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image.
The superoinferior and anteroposterior offset in the glenoid component were 0.42 ± 0.07, 0.50 ± 0.08 in the conventional group and 0.45 ± 0.03, 0.46 ± 0.02 in the PSG group. The inclination and version angles were -1.93° ± 4.31°, 2.27° ± 5.91° and 0.46° ± 0.02°, 3.38° ± 2.79°. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were 0.45 ± 0.12, 0.48 ± 0.15 in the conventional group and 0.46 ± 0.59 (=0.794), 0.46 ± 0.06 (=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment.
The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.
我们旨在评估在反式全肩关节置换术（RTSA）中使用我们新型的三维重建患者特异性导板（PSG）是否能实现关节盂和肱骨头组件的准确可靠植入。
使用20个新鲜冷冻尸体肩关节。通过计算机断层扫描图像评估PSG组（n = 10）和传统组（n = 10）手术前后植入物定位的准确性和可重复性。
传统组关节盂组件的上下和前后偏移分别为0.42±0.07、0.50±0.08，PSG组为0.45±0.03、0.46±0.02。倾斜角和旋转角分别为-1.93°±4.31°、2.27°±5.91°以及0.46°±0.02°、3.38°±2.79°。标准差显示PSG组差异较小。传统组肱骨头组件的前后和内外侧肱骨髓腔中心偏移分别为0.45±0.12、0.48±0.15，PSG组为0.46±0.59（=0.794）、0.46±0.06（=0.702）。PSG显示出明显更好的肱骨干对线。
使用三维重建的PSG可减少关节盂和肱骨头组件位置的变异性，并防止RTSA中出现极端定位误差。
