Rojas J Tomás, Jost Bernhard, Zipeto Claudio, Budassi Piero, Zumstein Matthias A
Shoulder, Elbow and Orthopaedic Sports Medicine, Sonnenhof Orthopaedics Center, Bern, Switzerland; Department of Orthopaedics and Trauma Surgery, Hospital San José-Clínica Santa María, Santiago, Chile.
Department of Orthopaedics and Trauma Surgery, Kantonsspital, Saint Gallen, Switzerland.
J Shoulder Elbow Surg. 2023 Dec;32(12):e587-e596. doi: 10.1016/j.jse.2023.05.002. Epub 2023 Jun 3.
Navigated augmented reality (AR) through a head-mounted display (HMD) may lead to accurate glenoid component placement in reverse shoulder arthroplasty (RSA). The purpose of this study is to evaluate the deviation between planned, intra- and postoperative inclination, retroversion, entry point, depth, and rotation of the glenoid component placement assisted by a navigated AR through HMD during RSA.
Both shoulders of 6 fresh frozen human cadavers, free from fractures or other bony pathologies, were used. Preoperative computed tomography (CT) scans were used for the 3-dimensional (3D) planning. The glenoid component placement was assisted using a navigated AR system through an HMD in all specimens. Intraoperative inclination, retroversion, depth, and rotation were measured by the system. A postoperative CT scan was performed. The pre- and postoperative 3D CT scan reconstructions were superimposed to calculate the deviation between planned and postoperative inclination, retroversion, entry point, depth, and rotation of the glenoid component placement. Additionally, a comparison between intra- and postoperative values was calculated. Outliers were defined as >10° inclination, >10° retroversion, >3 mm entry point.
The registration algorithm of the scapulae prior to the procedure was correctly completed for all cases. The deviations between planned and postoperative values were 1.0° ± 0.7° for inclination, 1.8° ± 1.3° for retroversion, 1.1 ± 0.4 mm for entry point, 0.7 ± 0.6 mm for depth, and 1.7° ± 1.6° for rotation. The deviation between intra- and postoperative values were 0.9° ± 0.8° for inclination, 1.2° ± 1.1° for retroversion, 0.6 ± 0.5 mm for depth, and 0.3° ± 0.2° for rotation. There were no outliers between planned and postoperative parameters.
In this study, the use of a navigated AR system through an HMD for RSA led to low deviation between planned and postoperative values and between intra- and postoperative parameters.
通过头戴式显示器(HMD)的导航增强现实(AR)技术可能有助于在反肩关节置换术(RSA)中实现肩胛盂假体的精准植入。本研究旨在评估在RSA手术中,通过HMD的导航AR辅助下,肩胛盂假体植入的计划值与术中及术后的倾斜度、后倾角度、入点、深度和旋转角度之间的偏差。
使用6具无骨折或其他骨质病变的新鲜冷冻人体尸体的双侧肩部。术前计算机断层扫描(CT)用于三维(3D)规划。在所有标本中,通过HMD使用导航AR系统辅助肩胛盂假体植入。术中倾斜度、后倾角度、深度和旋转角度由该系统测量。术后进行CT扫描。将术前和术后的3D CT扫描重建图像叠加,以计算肩胛盂假体植入的计划值与术后倾斜度、后倾角度入点、深度和旋转角度之间的偏差。此外,还计算了术中与术后数值之间的比较。异常值定义为倾斜度>10°、后倾角度>10°、入点>3 mm。
所有病例术前肩胛骨的配准算法均正确完成。计划值与术后值之间的偏差为:倾斜度1.0°±0.7°,后倾角度1.8°±1.3°,入点1.1±0.4 mm,深度0.7±0.6 mm,旋转角度1.7°±1.6°。术中与术后值之间的偏差为:倾斜度0.9°±0.8°,后倾角度1.2°±1.1°,深度0.6±0.5 mm,旋转角度0.3°±0.2°。计划值与术后参数之间无异常值。
在本研究中,通过HMD的导航AR系统用于RSA手术,使计划值与术后值以及术中与术后参数之间的偏差较小。