Intraoperative Navigation in Reverse Shoulder Arthroplasty: Advantages and Future Prospects
Peter Boufadel, Ryan Lopez, Mohamad Y. Fares, Mohammad Daher, Dineysh Dhytadak, Lawrence V. Gulotta, Joseph A. Abboud
Abstract
Reverse total shoulder arthroplasty (RSA) has experienced a significant increase in incidence over the past decade, with projections indicating continued exponential growth. 1)This increase can be attributed to its evolving surgical techniques, improving implant technology, and well-established success in the treatment of various shoulder pathologies, most commonly rotator cuff tear arthropathy. [1][2][3] Accurate positioning and secure initial fixation of the glenoid component are critical factors for success in RSA. [4][5]][6] Malposition of the glenoid component can result in scapular notching, which can subsequently cause pain, diminished function, instability, and glenoid loosening. 4,[6][7][8] Thus, positioning of the baseplate inferiorly on the glenoid without introducing excessive superior tilt is imperative for optimizing impingement-free range of motion (ROM). 4,5,7)ptimization of the length and number of peripheral screws and targeting areas characterized by high bone quality to attain the strongest purchase is essential for stable fixation as well. 4,9)However, severely pathologic glenoids with bone deformities and/or poor bone stock can present challenges that may compromise fixation and correct positioning of the baseplate.Advancements in shoulder arthroplasty have been developed in the hopes of improving the accuracy of glenoid component implantation and prolonging implant longevity, particularly for complex glenoid deformities.Intraoperative navigation, also known as computerassisted surgery, is a modern technology that uses detailed 3-dimensional (3D) preoperative planning to provide the surgeon with real-time feedback during implantation in order to enhance precision, accuracy, and safety.