Troiano Elisa, Masini Azzurra, Colasanti Giovanni Battista, Drago Caterina, Giannotti Stefano, Mondanelli Nicola
Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy.
Section of Orthopedics, Azienda Ospedaliero Universitaria Senese, Policlinico Santa Maria alle Scotte, Viale Mario Bracci 16, 53100 Siena, Italy.
Medicina (Kaunas). 2025 Apr 18;61(4):749. doi: 10.3390/medicina61040749.
: Reverse shoulder arthroplasty (RSA) is an effective surgical procedure for treating end-stage rotator cuff arthropathy, but it is burdened by a relatively high complication rate, mainly due to glenoid component failure. Preoperative planning and intraoperative navigation based on three-dimensional computed tomography (3D CT) scans have proven to be efficient tools for improving the accuracy and stability of the glenoid component. However, this technology is still developing, and there is currently little available research on the subject, especially where clinical outcomes are concerned. The purpose of this retrospective observational study is to report the radiographic and clinical outcomes of a consecutive series of patients that underwent RSA with the use of these new technologies, compared to a standard procedure. : A consecutive series of 80 patients underwent RSA for shoulder osteoarthritis by a single surgeon at a single institution with a mean follow-up of 41.9 ± 23.6 months (range 24-108) and were divided into two groups according to the surgical technique employed (conventional or navigated surgery), and they were clinically and radiographically assessed at 1, 3, 6, and 12 months after surgery, and then annually. : No statistically significant differences were highlighted among the two groups according to complication rate, radiographical glenoid notching, and clinical outcomes. However, a statistically significant difference was observed in screw number and length and surgical time. In the navigated group, fewer screws with longer lengths had been implanted, with a longer surgical time. : The use of 3D CT-based preoperative planning and intraoperative navigation is a safe procedure and produces comparable results with respect to standard instrumentation, without an increased risk of complications. It allowed to achieve higher stability of the implant, saving bone stock due to the use of fewer and longer screws than in a conventional procedure. This could also eventually result in a higher longevity of the implant itself.
反肩关节置换术（RSA）是治疗终末期肩袖关节病的一种有效手术方法，但它存在相对较高的并发症发生率，主要原因是关节盂假体失败。基于三维计算机断层扫描（3D CT）扫描的术前规划和术中导航已被证明是提高关节盂假体准确性和稳定性的有效工具。然而，这项技术仍在发展，目前关于该主题的可用研究很少，尤其是在临床结果方面。这项回顾性观察研究的目的是报告与标准手术相比，连续一系列使用这些新技术接受RSA手术的患者的影像学和临床结果。
连续80例患者在单一机构由一名外科医生进行RSA治疗肩骨关节炎，平均随访41.9±23.6个月（范围24 - 108个月），并根据所采用的手术技术（传统手术或导航手术）分为两组，在术后1、3、6和12个月以及之后每年进行临床和影像学评估。
根据并发症发生率、影像学关节盂切迹和临床结果，两组之间未发现统计学上的显著差异。然而，在螺钉数量和长度以及手术时间方面观察到统计学上的显著差异。在导航组中，植入的螺钉数量较少但长度较长，手术时间也较长。
使用基于3D CT的术前规划和术中导航是一种安全的手术方法，与标准器械相比产生的结果相当，且并发症风险没有增加。它能够实现更高的植入物稳定性，由于使用的螺钉比传统手术更少且更长，从而节省了骨量。这最终也可能导致植入物本身具有更长的使用寿命。
