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Article: Surgeon-designed patient-specific instrumentation improves glenoid component screw placement for reverse total shoulder arthroplasty in a population with small glenoid dimensions

TitleSurgeon-designed patient-specific instrumentation improves glenoid component screw placement for reverse total shoulder arthroplasty in a population with small glenoid dimensions
Authors
Keywords3D printing
Custom surgical template
Glenosphere
Reverse shoulder replacement
Reverse total shoulder arthroplasty
Screw length
Issue Date10-Feb-2023
PublisherSpringer
Citation
International Orthopaedics, 2023, v. 47, n. 5, p. 1267-1275 How to Cite?
Abstract

Purpose

Glenoid component loosening is a potential complication of reverse total shoulder arthroplasty (rTSA), occurring in part due to lack of adequate screw purchase in quality scapular bone stock. This study was to determine the efficacy of a surgeon-designed, 3D-printed patient-specific instrumentation (PSI) compared to conventional instrumentation (CI) in achieving longer superior and inferior screw lengths for glenoid component fixation.

Methods

A multi-centre retrospective analysis of patients who underwent rTSA between 2015 and 2020. Lengths of the superior and inferior locking screws inserted for fixation of the glenoid baseplate component were recorded and compared according to whether patients received PSI or CI. Secondary outcomes included operative duration and incidence of complications requiring revision surgery.

Results

Seventy-three patients (31 PSI vs. 42 CI) were analysed. Average glenoid diameter was 24.5 mm (SD: 3.1) and 81% of patients had smaller glenoid dimensions compared to the baseplate itself. PSI produced significantly longer superior (44.7 vs. 30.7 mm; P < 0.001) and inferior (43.0 vs. 31 mm; P < 0.001) mean screw lengths, as compared to CI. A greater proportion of maximal screw lengths for the given rTSA construct (48 mm) were observed in the PSI group (71.9% vs. 11.9% superior, 59.4% vs. 11.9% inferior). Operative duration was not statistically significantly different between the PSI and CI groups (150 min vs. 169 min, respectively; P = 0.229). No patients had radiographic loosening of the glenoid component with an average of 2-year follow-up.

Conclusion

PSI facilitates longer superior and inferior screw placement in the fixation of the glenoid component for rTSA. With sufficient training, PSI can be designed and implemented by surgeons themselves.


Persistent Identifierhttp://hdl.handle.net/10722/338717
ISSN
2023 Impact Factor: 2.0
2023 SCImago Journal Rankings: 0.877
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYung, Colin Shing-Yat-
dc.contributor.authorFang, Christian-
dc.contributor.authorFang, Evan-
dc.contributor.authorSiu, Yuk-Chuen-
dc.contributor.authorYee, Dennis King Hang-
dc.contributor.authorWong, Kevin Kwun-Hung-
dc.contributor.authorPoon, Kai-Chung-
dc.contributor.authorLeung, Matthew Man Fai-
dc.contributor.authorWan, Jonathan-
dc.contributor.authorLau, Tak-Wing-
dc.contributor.authorLeung, Frankie-
dc.date.accessioned2024-03-11T10:31:00Z-
dc.date.available2024-03-11T10:31:00Z-
dc.date.issued2023-02-10-
dc.identifier.citationInternational Orthopaedics, 2023, v. 47, n. 5, p. 1267-1275-
dc.identifier.issn0341-2695-
dc.identifier.urihttp://hdl.handle.net/10722/338717-
dc.description.abstract<h3>Purpose</h3><p>Glenoid component loosening is a potential complication of reverse total shoulder arthroplasty (rTSA), occurring in part due to lack of adequate screw purchase in quality scapular bone stock. This study was to determine the efficacy of a surgeon-designed, 3D-printed patient-specific instrumentation (PSI) compared to conventional instrumentation (CI) in achieving longer superior and inferior screw lengths for glenoid component fixation.</p><h3>Methods</h3><p>A multi-centre retrospective analysis of patients who underwent rTSA between 2015 and 2020. Lengths of the superior and inferior locking screws inserted for fixation of the glenoid baseplate component were recorded and compared according to whether patients received PSI or CI. Secondary outcomes included operative duration and incidence of complications requiring revision surgery.</p><h3>Results</h3><p>Seventy-three patients (31 PSI vs. 42 CI) were analysed. Average glenoid diameter was 24.5 mm (SD: 3.1) and 81% of patients had smaller glenoid dimensions compared to the baseplate itself. PSI produced significantly longer superior (44.7 vs. 30.7 mm; <em>P</em> < 0.001) and inferior (43.0 vs. 31 mm; <em>P</em> < 0.001) mean screw lengths, as compared to CI. A greater proportion of maximal screw lengths for the given rTSA construct (48 mm) were observed in the PSI group (71.9% vs. 11.9% superior, 59.4% vs. 11.9% inferior). Operative duration was not statistically significantly different between the PSI and CI groups (150 min vs. 169 min, respectively; <em>P</em> = 0.229). No patients had radiographic loosening of the glenoid component with an average of 2-year follow-up.</p><h3>Conclusion</h3><p>PSI facilitates longer superior and inferior screw placement in the fixation of the glenoid component for rTSA. With sufficient training, PSI can be designed and implemented by surgeons themselves.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofInternational Orthopaedics-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subject3D printing-
dc.subjectCustom surgical template-
dc.subjectGlenosphere-
dc.subjectReverse shoulder replacement-
dc.subjectReverse total shoulder arthroplasty-
dc.subjectScrew length-
dc.titleSurgeon-designed patient-specific instrumentation improves glenoid component screw placement for reverse total shoulder arthroplasty in a population with small glenoid dimensions-
dc.typeArticle-
dc.identifier.doi10.1007/s00264-023-05706-z-
dc.identifier.scopuseid_2-s2.0-85147775136-
dc.identifier.volume47-
dc.identifier.issue5-
dc.identifier.spage1267-
dc.identifier.epage1275-
dc.identifier.eissn1432-5195-
dc.identifier.isiWOS:000932835300002-
dc.identifier.issnl0341-2695-

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