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. 2024 Sep 19;9(3):954-959.
doi: 10.1016/j.jseint.2024.09.002. eCollection 2025 May.

The present and future of preoperative planning

Ruth A Delaney  1
Affiliations

The present and future of preoperative planning

Ruth A Delaney. JSES Int. .

Abstract

Preoperative planning for shoulder arthroplasty has become widely used for primary cases and now also in revision situations. From the initial, two-dimensional manual planning efforts on computed tomography scans, planning has evolved to now using three-dimensional planning software programs. A number of different programs exist with various methods underpinning their chosen landmarks and segmentation methods. Preoperative planning has allowed for development of execution tools to translate the preoperative plan to intraoperative reality. This article considers the particular relevance of preoperative arthroplasty planning to the shoulder joint, the current status of preoperative planning, the reasons to engage with preoperative planning, the execution tools available as an extension of preoperative planning, and the future of intraoperative execution technologies associated with planning. Preoperative planning is the foundation of prospective advances in these so-called enabling technologies and the future of preoperative planning will be shaped by a desire to continue to optimize execution techniques in shoulder arthroplasty, with the ultimate goal of using these techniques to achieve improved patient outcomes.

Keywords: Mixed reality; Navigation; Patient-specific guides; Planning software; Preoperative planning; Shoulder arthroplasty.

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Figures

Figure 1
Figure 1
A, B The best fit sphere model used by Stryker Blueprint to determine glenoid morphology. A fully automated algorithm mathematically creates a best-fit sphere incorporating data from all points of the glenoid surface to estimate the glenoid plane and glenoid centerline. The Center of the sphere is determined (dot), and the radial line connecting the center of gravity of the glenoid face to the center of the sphere is the glenoid centerline. Version and inclination are then calculated relative to this centerline, using axial axis and coronal axis lines as reference.
Figure 2
Figure 2
(A) 2D CT view of glenoid inclination. (B) 3D software view of glenoid inclination. (C) RSA angle for the same case. 2D, two dimensional; CT, computed tomography; 3D, three dimensional; RSA, reverse shoulder arthroplasty.
Figure 3
Figure 3
Intraoperative use of a head-mounted display for mixed reality.
See this image and copyright information in PMC

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