Wednesday, November 12, 2014

Three dimensional planning and patient specific glenoid guides: a virtual study in cadevaric scapulae without arthritis

Three-dimensional planning and use of patient-specific guides improve glenoid component position: an in vitro study.

These authors evaluated the reliability and precision of three-dimensional planning and use of patient-specific guides in the simulated placement of a glenoid guide pin in 18 normal dry cadaver scapulae.

Quantitative analysis of guide pin positioning demonstrated a good correlation between preoperative planning and the achieved position of the guide pin.

Comment: This study was performed in dry normal scapulae. It focused on pin placement - glenoid reaming and actual component placement were not included.  From the photographs, it appears that complete exposure of the perimeter of the glenoid is necessary to allow for insertion of the pin guide. Thus the ability to use this system in actual shoulder arthroplasty where exposure can be difficult  - particularly in cases of glenoid retroversion - is unknown. The cost of the system and the time necessary in its implementation are not provided in this manuscript - thus the value (benefit/cost) cannot be determined. See this related post.

We do not use a guide pin in shoulder arthroplasties out of concern for pin breakage or inadvertent pin advancement into the chest. Our technique for glenoid insertion is shown here.


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