3D fluoroscopic navigated reaming of the glenoid for total shoulder arthroplasty (TSA)

Figures & data

Figure 1. Operative setting of the navigated procedure using a 3D image intensifier and a radiolucent shoulder table.

Figure 2. Top: Preoperative threshold adjustment to bony structures (A1, A2). Center: Preoperative assessment of the glenoid version (B1) and planning of the guide wire trajectory on the navigated image data set (B2): preoperative glenoid version is 5° (pink), thus, the angle for eccentric reaming to achieve glenoid version of −10° is defined as 15° (yellow). Bottom: System verification (C1) and real-time guidance of the navigated drill sleeve along the planned trajectory (C2).

Figure 3. Top: Equipment for the navigated procedure (A1) and intraoperative guidance (A2). Bottom: 3D fluoroscopic assessment of the shoulder joint preoperatively (B1) and after navigated eccentric reaming of the glenoid (B2).

Table I.  Comparison of the standard freehand technique and the navigated procedure. Values are given as means and standard deviations with ranges in parentheses.

	Standard	Navigation
Procedure time (min)	27.6 ± 5.6 (16 to 35)	38.9 ± 5.6 (30 to 45)**
Postop. glenoid version (°)	−5.1 ± 4.1 (3 to −10)	−9.8 ± 3.8 (−7 to −13)*
Deviation from planning (°)	5.8 ± 3.7 (0 to 10)	1.0 ± 1.0 (0 to 3)**

*p < 0.05 vs. Standard. **p < 0.01 vs. Standard.