Abstract
Purpose of study:
Reverse shoulder arthroplasty is effective in the management of symptomatic arthritic shoulders with a non-reconstructable rotator cuff. Optimal orientation and initial fixation of the glenoid component is correlated with improved outcomes. This may be difficult to achieve with distorted glenoid morphology. The authors present a previously undescribed system for accurate, consistent and reliable screw placement for fixation of the glenoid component with the desired version during reverse shoulder arthroplasty.
Description of methods:
The pre-operative CT scan images are used to construct a scapula model (Medical Image Processing software, CustomMed Orthopaedics)allowing the surgeon to determine the optimal position for screw placement based on available bone stock. A custom drill guide is made from polyamide, which is sterilized in an autoclave and fitted to the glenoid intra-operatively prior to reaming. The system minimizes the likelihood of malposition of glenoid components and is compatible with all arthroplasty systems.
Summary of results:
The technique has been performed on 5 patients after informed consent. Post-operative CT images demonstrate intended component version and screw position in all cases. Patients are being recruited for a multicenter prospective trial.
Conclusion:
The authors present a new technique for achieving optimal screw position in fixation of glenoid components. A prospective trial is underway which aims to prove through post-operative imaging that intended glenoid version and screw placement was achieved and show improved long term results.
