Glenoid component placement in reverse shoulder arthroplasty assisted with augmented reality through a head-mounted display leads to low deviation between planned and post-operative parameters.

Rojas, J Tomás; Jost, Bernhard; Zipeto, Claudio; Budassi, Piero; Zumstein, Matthias A (2023). Glenoid component placement in reverse shoulder arthroplasty assisted with augmented reality through a head-mounted display leads to low deviation between planned and post-operative parameters. Journal of shoulder and elbow surgery, 32(12), e587-e596. Elsevier 10.1016/j.jse.2023.05.002

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BACKGROUND

Navigated augmented reality (AR) through a head-mounted display (HMD) may lead to accurate glenoid component placement in reverse shoulder arthroplasty (RSA). The purpose of this study is to evaluate the deviation between planned, intra- and postoperative inclination, retroversion, entry point, depth and rotation of the glenoid component placement assisted by a navigated AR through HMD during RSA.

METHODS

Both shoulders of six fresh frozen human cadavers, free from fractures or other bony pathologies, were used. Preoperative computed tomography (CT) scans were used for the three-dimensional (3D) planning. The glenoid component placement was assisted using a navigated AR system through a HMD in all specimens. Intraoperative inclination, retroversion, depth and rotation were measured by the system. A postoperative CT scan was performed. The pre- and postoperative 3D CT scan reconstructions were superimposed to calculate the deviation between planned and postoperative inclination, retroversion, entry point, depth and rotation of the glenoid component placement. Additionally, a comparison between intra- and postoperative values was calculated. Outliers were defined as >10° inclination, >10° retroversion, >3 mm entry point.

RESULTS

The registration algorithm of the scapulae prior to the procedure was correctly completed for all cases. The deviations between planned and postoperative values were 1.0 ± 0.7° for inclination, 1.8 ± 1.3° for retroversion, 1.1± 0.4mm for entry point, 0.7 ± 0.6mm for depth, and 1.7 ± 1.6° for rotation. The deviation between intra- and postoperative values were 0.9±0.8° for inclination, 1.2±1.1° for retroversion, 0.6±0.5mm for depth, and 0.3±0.2° for rotation. There were no outliers between planned and postoperative parameters.

CONCLUSION

In this study, the use of a navigated AR system through a HMD for RSA led to low deviation between planned and postoperative values and between intra- and postoperative parameters.

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