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J Bone Joint Surg Am. 2015 Apr 15;97(8):651-8. doi: 10.2106/JBJS.N.00493.

Three-dimensional imaging and templating improve glenoid implant positioning.

Author information

1
Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute (J.P.I., S.W., E.R., T.E.P., and E.T.R.), Imaging Institute (N.S.), and Department of Biomedical Engineering, Lerner Research Institute (B.J.J.), Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195. E-mail address for J.P. Iannotti: iannotj@ccf.org.

Abstract

BACKGROUND:

Preoperative quantitative assessment of glenoid bone loss, selection of the glenoid component, and definition of its desired location can be challenging. Placement of the glenoid component in the desired location at the time of surgery is difficult, especially with severe glenoid pathological conditions.

METHODS:

Forty-six patients were randomly assigned to three-dimensional computed tomographic preoperative templating with either standard instrumentation or with patient-specific instrumentation and were compared with a nonrandomized group of seventeen patients with two-dimensional imaging and standard instrumentation used as historical controls. All patients had postoperative three-dimensional computed tomographic metal artifact reduction imaging to measure and to compare implant position with the preoperative plan.

RESULTS:

Using three-dimensional imaging and templating with or without patient-specific instrumentation, there was a significant improvement achieving the desired implant position within 5° of inclination or 10° of version when compared with two-dimensional imaging and standard instrumentation.

CONCLUSION:

Three-dimensional assessment of glenoid anatomy and implant templating and the use of these images at the time of surgery improve the surgeon's ability to place the glenoid implant in the desired location.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01801241.

PMID:
25878309
DOI:
10.2106/JBJS.N.00493
[Indexed for MEDLINE]

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