Tashjian Robert Z, Beck Lindsay, Stertz Irene, Chalmers Peter N
Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, USA.
Shoulder Elbow. 2021 Oct;13(5):492-501. doi: 10.1177/1758573220908903. Epub 2020 Mar 13.
Computer assisted planning without patient specific instrumentation may be utilized to guide reverse total shoulder arthroplasty baseplate placement. The purpose of this study was to determine the difference between planned and achieved inclination and retroversion correction with three-dimensional preoperative computer assisted planning in reverse total shoulder arthroplasty without patient specific instrumentation with bone grafting for severe glenoid erosion.
Preoperative three-dimensional computer assisted planning without patient specific instrumentation was performed on 15 patients undergoing primary reverse total shoulder arthroplasty with glenoid bone grafting for severe glenoid erosion. On preoperative and immediate postoperative computed tomography slices, two-dimensional retroversion and inclination were measured. Preoperative three-dimensional baseline retroversion and inclination and planned postoperative three-dimensional retroversion and inclination were measured. Planned and achieved version and inclination changes were compared.
The planned and achieved retroversion corrections were 18° and 12°, respectively (p < 0.001). The planned and achieved inclination corrections were 11° and 11°, respectively (p = 0.803).
Three-dimensional computer assisted planning without patient specific instrumentation in the setting of reverse total shoulder arthroplasty with severe glenoid erosion requiring bone grafting can accurately guide baseplate placement. All cases in which failure to correct retroversion or inclination within 10° of planning occurred in patients with severe erosion (B3 or E3 glenoids), therefore patient specific guides may be warranted in these cases to improve accuracy of implantation.
Level IV, retrospective case series.
在不使用患者特异性器械的情况下，计算机辅助规划可用于指导反式全肩关节置换术基板的放置。本研究的目的是确定在不使用患者特异性器械且因严重肩胛盂侵蚀而进行植骨的反式全肩关节置换术中，术前三维计算机辅助规划的计划倾斜度和后倾矫正度与实际实现的倾斜度和后倾矫正度之间的差异。
对15例因严重肩胛盂侵蚀而接受初次反式全肩关节置换术并行肩胛盂植骨的患者，在不使用患者特异性器械的情况下进行术前三维计算机辅助规划。在术前和术后即刻的计算机断层扫描切片上，测量二维后倾和倾斜度。测量术前三维基线后倾和倾斜度以及计划的术后三维后倾和倾斜度。比较计划的和实际实现的后倾和倾斜度变化。
计划的和实际实现的后倾矫正度分别为18°和12°（p < 0.001）。计划的和实际实现的倾斜矫正度分别为11°和11°（p = 0.803）。
在因严重肩胛盂侵蚀需要植骨的反式全肩关节置换术中，不使用患者特异性器械的三维计算机辅助规划可准确指导基板放置。在严重侵蚀（B3或E3肩胛盂）患者中，所有未在计划的10°范围内矫正后倾或倾斜度的病例均出现这种情况，因此在这些病例中可能需要使用患者特异性导向器以提高植入的准确性。
IV级，回顾性病例系列。
