| Popis: |
Background Shoulder arthroplasty is technically demanding and can be associated with failures due to implant loosening, especially in the presence of posterior glenoid bone loss. Novel preoperative planning has been employed more frequently in an attempt to improve implant positioning, however, there is little data comparing the effectiveness of various systems for shoulder arthroplasty. Our goal was to assess the reliability and validity of preoperative planning software systems for measurements and implant selection. Methods A retrospective analysis was done of 80 patients who underwent total shoulder arthroplasty. Preoperative computed tomography studies were used to create a preoperative plan using 3 software systems: independent preoperative plan software (IPPS) and 2 automated manufacturer preoperative simulation (AMPS I and II). We collected preoperative native and implant version and inclination and implant size from each software. Simulated plans of each patient were compared to one another. Results The mean age of our population was 61 years old (±12), 51.3% females and 48.8% males. The mean native version measured by IPPS was −9.1° ± 11.3°, by AMPS I was −11.7° ± 8° and by AMPS II software was −11° ± 13.4° The mean native inclination for IPPS was 4.7° ± 6.8°, for AMPS I was 10.4° ± 5.9° and for AMPS II software was 7.76° ± 7.2° The mean implant version for IPPS was −4.8° ± 6.5°, for AMPS I was −6.73° ± 2.6° and for AMPS II software was −5.4° ± 5° The mean implant inclination suggested by IPPS was 2.04° ± 4.4°, by AMPS I was 3.5° ± 3.2° and by AMPS II software was 7.04° ± 7.2° Five of 14 comparisons resulted in statistically significant differences. Our results demonstrated strong positive correlations (r > 0.7) between AMPS I and AMPS II for Native Version and Implant Inclination. When implant diameter/size was compared between IPPS and AMPS II, AMPS I and AMPS II, we found a matching rate of 66.7% and 100%, respectively. Conclusion Our results support the use of either independent or commercially available preoperative simulation software to reliably measure pathology and accurately guide intraoperative implant selection. Notwithstanding, some manufacturer's software (AMPS II) provide more critical data, enhancing precision in implant placement and correction of pathologic bone loss. Level of evidence Level III. |
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