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3-D imaging improves surgeons’ ability to choose location for glenoid implant
At the time of surgery, the use of 3-D imaging and templating with or without patient-specific instruments improved the surgeon’s ability to place the glenoid implant the desired location, according to study results.
Researchers randomly assigned 46 patients to surgical planning for glenoid implant location with either 3-D CT preoperative templating using standard instruments or with patient-specific (intelligent reusable and adjustable) instruments. The patients were then compared with 17 historical control patients who had surgical planning with 2-D imaging and standard instruments. Additionally, the researchers performed CT metal artifact reduction imaging on all patients postoperatively to measure and compare the position of the implant with chosen preoperative surgical plan.
For both all imaging groups, surgeons chose between using a standard or augmented glenoid component at time of surgery. No significant differences were observed between the patients’ preoperative glenoid pathological condition severity.
Results showed, compared with the 2-D imaging control group, the 3-D imaging groups had a significant improvement in positioning of the implant within the desired location, within an inclination of 5° and a version of 10°.
The 3-D imaging groups were not significantly different with regard to the frequency of augmented component use, according to the researchers, and none of the patients in the 2-D imaging control group required an augmented glenoid component. However, the researchers determined retrospectively that five of the 17 patients in the 2-D control group did require use of an augmented component to achieve the correct glenoid position, which resembled the frequency seen among patients in the 3-D groups.
When the 3-D imaging group was compared with the 3-D imaging plus intelligent reusable instrument technology group, the researchers found no significant differences with regard to implant position, accuracy of implant placement or the severity of glenoid bone loss. – by Monica Jaramillo
Disclosures: Iannotti reports receiving grants from the State of Ohio Biomedical Research and Development Third Frontier Program. Please see the full study for a list of all other authors’ relevant financial disclosures.