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. 2023 Jul;143(7):3735-3741.
doi: 10.1007/s00402-022-04571-6. Epub 2022 Aug 13.

Stem size prediction in shoulder arthroplasty with preoperative 3D planning

Thomas Wittmann  1 , Nima Befrui  2 , Tim Rieger  2 , Patric Raiss  2
Affiliations

Stem size prediction in shoulder arthroplasty with preoperative 3D planning

Thomas Wittmann et al. Arch Orthop Trauma Surg. 2023 Jul.

Abstract

Introduction: Three-dimensional surgical planning software provides virtual reconstructions of the shoulder with automated joint indices for a preoperative case assessment. The aim of this single center study was to evaluate the concordance between the preoperatively selected humeral components and the final implants used in shoulder arthroplasty.

Methods: 129 cases who had undergone anatomic (n = 16) or reverse shoulder arthroplasty (n = 117) using the same type of uncemented short stem implant and were included for review in this study. The type of arthroplasty, stem size, stem inclination, tray-offset and liner-thickness were noted preoperatively and compared to the final implant specifications used in surgery.

Results: The type of arthroplasty matched the surgical plan in 99.2% of cases, as one case was converted from RSA to TSA. The concordance of planned to implanted stem size was 44.2% and the planned size was in range of one adjacent size in 87.6% of cases. Stem inclination in TSA matched the surgical plan in 50% of cases. Tray offset in RSA was predicted correctly in 65% and liner-thickness matched the surgical plan in 98.3% of cases.

Conclusion: Despite a low degree of concordance of planned to implanted stem sizes of 44.2%, the choice of stem size was found to be in range of one adjacent size in 87.6% of cases. Further investigations of other contributing factors are necessary to increase the accuracy of the preoperative selection of humeral implants.

Level of evidence: level IV, retrospective case study.

Keywords: 3D planning; Concordance; Shoulder arthroplasty; Shoulder replacement; Uncemented stem.

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References

    1. Austin DC, Torchia MT, Cozzolino NH et al (2019) Decreased Reoperations and improved outcomes with reverse total shoulder arthroplasty in comparison to hemiarthroplasty for geriatric proximal humerus fractures: a systematic review and meta-analysis. J Orthop Trauma 33:49–57. https://doi.org/10.1097/BOT.0000000000001321 - DOI - PubMed
    1. Petrillo S, Longo UG, Papalia R et al (2017) Reverse shoulder arthroplasty for massive irreparable rotator cuff tears and cuff tear arthropathy: a systematic review. Musculoskelet Surg 101:105–112. https://doi.org/10.1007/s12306-017-0474-z - DOI - PubMed
    1. Walch G, Young AA, Boileau P et al (2012) Patterns of loosening of polyethylene keeled glenoid components after shoulder arthroplasty for primary osteoarthritis: results of a multicenter study with more than five years of follow-up. J Bone Joint Surg Am 94:145–150. https://doi.org/10.2106/JBJS.J.00699 - DOI - PubMed
    1. Bohsali KI, Bois AJ, Wirth MA (2017) Complications of Shoulder Arthroplasty. J Bone Joint Surg Am 99:256–269. https://doi.org/10.2106/JBJS.16.00935 - DOI - PubMed
    1. Schnetzke M, Rick S, Raiss P et al (2018) Mid-term results of anatomical total shoulder arthroplasty for primary osteoarthritis using a short-stemmed cementless humeral component. Bone Joint J 100-B:603–609. https://doi.org/10.1302/0301-620X.100B5.BJJ-2017-1102.R2 - DOI - PubMed

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