Basic ScienceThree-dimensional planning and use of patient-specific guides improve glenoid component position: an in vitro study
Section snippets
Materials and methods
Eighteen dry cadaveric scapulae (bilateral specimens from 6 women and 3 men) were obtained from our local anatomy laboratory. The average age of the cadaveric specimens was 78 years. A physical examination excluded any previous disease, fracture, or obvious osteoarthritis. A CT scan of each cadaveric scapula was performed on a Siemens machine (Siemens Healthcare, Malvern, PA, USA). The CT parameters were 140 kV, 180 mAs, and image matrix of 512 × 512. The field of view was adapted with a
Results
The mean differences in pin positioning in comparing planned preoperative guide pin position with the pin placement achieved by use of the patient-specific guides are illustrated in Table I. The mean error in 3D orientation of the pin was 2.39° ± 1.16° (range, 0.53°-4.28°). Average entry point position error was 1.05 ± 0.31 mm (range, 0.60-1.53 mm). Mean inclination angle error was 1.42° ± 1.37° (range, 0.09°-4.55°). The average error in version angle was 1.64° ± 1.01° (range, 0.17°-3.21°).
Discussion
This in vitro study has 2 major findings. First, it demonstrates that the use of a new automated software system enables the surgeon to perform 3D reconstruction and preoperative planning of the scapula based on CT scan images without the help of a technician or an engineer. Second, patient-specific guides manufactured by a 3D printer, based on preoperative planning data, enable the surgeon to reliably and precisely insert a guide pin in the desired glenoid location to correct glenoid
Conclusion
This in vitro study validates the use of the Glenosys software for fully automated 3D reconstruction of the scapula and production of patient-specific guides for glenoid component implantation. It demonstrates the reliability and precision of preoperative planning software and patient-specific guides for glenoid component placement in total shoulder arthroplasty.
Disclaimer
This study was supported by a BPI France development grant A1209018 E. The funds were used to pay the salary for one of the authors (Jean Chaoui).
Jean Chaoui, Gilles Walch, and Pascal Boileau own stock equity in Imascap. The other authors, their immediate families, and any research foundations with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.
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The Institutional Review Board of the ethical committee of the Hôpital Privé Jean Mermoz and the Centre Orthopédique Santy approved this project (Study 2014-01).