Improved accuracy of glenoid positioning in total shoulder arthroplasty with intraoperative navigation: A prospective-randomized clinical study

Hypothesis

The correct implantation of the glenoid component is of paramount importance in total shoulder arthroplasty (TSA). We hypothesized that the accuracy of the glenoid positioning in the transverse plane can be improved using intraoperative navigation.

Materials and methods

This prospective, randomized clinical study comprised 2 groups of 10 patients each with osteoarthritis of the shoulder TSA, with or without intraoperative navigation. Glenoid version was measured on axial computed tomography scans preoperatively and 6 weeks postoperatively.

Results

The operating time was significantly longer in the navigation group (169.5 ± 15.2 vs 138 ± 18.4 min). We found an average change of retroversion from 15.4° ± 5.8° (range, 3.0°-24.0°) preoperatively to 3.7° ± 6.3° (range, –8.0° to 15.0°) postoperatively in the navigation group compared with 14.4° ± 6.1° (range, 2.0°-24.0°) preoperatively to 10.9° ± 6.8° (range, 0.0°-19.0°) postoperatively in the group without navigation (P = .021).

Conclusion

We found an improved accuracy in glenoid positioning in the transverse plane using intraoperative navigation. The validity of the study is limited by the small number, which advocates continuation with more patients and longer follow-up.

Level of evidence

Level 2; Therapeutic study.

Keywords: Total shoulder arthroplasty, computer assisted surgery, glenoid version, computer-tomography