Work

Impact Of Three-Dimensional Humeral Planning And Standard Transfer Instrumentation On Reconstruction Of Native Humeral Anatomy For Anatomic Total Shoulder

Year: 2024

Type: article

Abstract: Background: Humeral head osteotomy and stem insertion are important in reverse total shoulder arthroplasty (RTSA).However, few studies have investigated methods to improve the surgical outcome of the humeral component.Therefore, we designed and 3D-printed a PSI guide for both humeral osteotomy and stem insertion.Methods: Five RTSA cases were performed using a PSI guide.Preoperative planning was conducted with Reconeasy Software (Seeann Solution, Incheon, Korea), and the PSI guides were manufactured using a 3D printer.During surgery, a PSI guide for humeral head osteotomy was fitted to the lateral surface of the bicipital groove.Following humeral head resection, a separate PSI guide for stem insertion was fitted onto the resected head surface, facilitating reaming and broaching.The humeral stem was then inserted along the pre-reamed canal.Cut height(mm), version (degrees), neck-shaft angle (degrees), and stem alignment (degrees) were recorded and compared statistically to RTSA procedures performed without a PSI guide.Results: The PSI group exhibited significantly improved outcomes compared to the non-PSI group, reflected in the mean values for several key parameters.Humeral head osteotomy height averaged 25.9 mm in the PSI group compared to 22.7 mm in the non-PSI group (p¼0.013).Similarly, the mean version difference between the native humerus and the implanted component was 1.6 degrees in the PSI group versus 6.45 degrees in the non-PSI group (p¼0.013).While the mean neck-shaft angle did not differ significantly between the groups (132.7 degrees in PSI vs. 134.9degrees in non-PSI, p¼0.129), the mean stem alignment showed a clear improvement in the PSI group, averaging 0.8 degrees compared to 3.76 degrees in the non-PSI group (p¼0.008).Conclusion: The PSI group demonstrated significantly improved surgical outcomes compared to the non-PSI group.While this pilot study evaluated the PSI guide for humeral head osteotomy and stem insertion in a limited sample size, our findings suggest that this technology has the potential to enhance the overall surgical outcome of these procedures.

Source: JSES International

DOI: 10.1016/j.jseint.2024.08.085

Authors: Brian C. Werner, Timothy Lenters, John M. Tokish

Institutions: University of Virginia, Trinity Health Grand Rapids, Mayo Clinic in Arizona

Language: English

Topic: Shoulder Injury and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250