2.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
Clinics in Orthopedic Surgery 2024;16(5):679-687
Intraoperative navigation is a novel technology that can provide real-time feedback to the surgeon during implantation and enhance the accuracy and precision of glenoid component positioning. Applications of intraoperative navigation systems have demonstrated increased precision in baseplate version and inclination, as well as improved baseplate screw placement, with fewer screws used and greater purchase length achieved when compared to standard instrumentation. Early clinical studies have shown favorable results, with significantly improved patient-reported and clinical outcomes and decreased complications. The implementation of intraoperative navigation is associated with a short learning curve and a minimal increase in operative time. Nevertheless, further research is necessary to substantiate the clinical benefit of navigation and evaluate its economic cost-effectiveness and impact on implant survival. Augmented reality and robotic-assisted surgery are additional emerging technologies that, while novel, hold the potential to further advance the field of shoulder arthroplasty.
3.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
Clinics in Orthopedic Surgery 2024;16(5):679-687
Intraoperative navigation is a novel technology that can provide real-time feedback to the surgeon during implantation and enhance the accuracy and precision of glenoid component positioning. Applications of intraoperative navigation systems have demonstrated increased precision in baseplate version and inclination, as well as improved baseplate screw placement, with fewer screws used and greater purchase length achieved when compared to standard instrumentation. Early clinical studies have shown favorable results, with significantly improved patient-reported and clinical outcomes and decreased complications. The implementation of intraoperative navigation is associated with a short learning curve and a minimal increase in operative time. Nevertheless, further research is necessary to substantiate the clinical benefit of navigation and evaluate its economic cost-effectiveness and impact on implant survival. Augmented reality and robotic-assisted surgery are additional emerging technologies that, while novel, hold the potential to further advance the field of shoulder arthroplasty.
4.Anatomic factors associated with degeneration and fraying of the coracoacromial ligament
Ryan LOPEZ ; Jaspal SINGH ; Mohammad GHORAISHIAN ; Thema NICHOLSON ; Stephen GATES ; Surena NAMDARI
Clinics in Shoulder and Elbow 2024;27(1):26-31
The coracoacromial ligament (CAL) is frequently observed to be damaged during arthroscopy and it is unclear how demographic, anatomic, and radiographic factors are related to CAL degeneration in full-thickness rotator cuff tears. Methods: A prospective study was conducted of patients at a single institution undergoing shoulder arthroscopy for first-time, full-thickness rotator cuff tears. We evaluated preoperative anteroposterior radiographs to obtain critical shoulder angle, glenoid inclination, acromial index, acromiohumeral distance, lateral acromial angle, and acromial morphology. We documented CAL quality, rotator cuff tear size and pattern during arthroscopy. Multiple logistic regression was used to identify predictive factors for encountering severe CAL fraying during arthroscopy. Results: Shoulders had mild CAL degeneration in 58.1% of cases, whereas severe CAL degeneration was present in 41.9% of shoulders. Patients with severe CAL attrition were significantly older (62.0 years vs. 58.0 years, P=0.042). Shoulders with severe CAL attrition had large rotator cuff tears in 54.1% of cases (P<0.001), and tears involving the infraspinatus (63.2% vs. 29.6%, P=0.003). The severe degeneration group was more likely to have a larger critical shoulder angle measurement on preoperative radiographs than those in the mild attrition group (36.1°±3.6° [range, 30°–45°] vs. 34.1°±3.8° [range, 26°–45°], P=0.037). Conclusions: While the clinical impact of CAL degeneration remains uncertain, increased severity of CAL degeneration is associated with older age, larger rotator cuff tear size, presence of infraspinatus tearing, and increased preoperative critical shoulder angle. Level of evidence: III.
5.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
Clinics in Orthopedic Surgery 2024;16(5):679-687
Intraoperative navigation is a novel technology that can provide real-time feedback to the surgeon during implantation and enhance the accuracy and precision of glenoid component positioning. Applications of intraoperative navigation systems have demonstrated increased precision in baseplate version and inclination, as well as improved baseplate screw placement, with fewer screws used and greater purchase length achieved when compared to standard instrumentation. Early clinical studies have shown favorable results, with significantly improved patient-reported and clinical outcomes and decreased complications. The implementation of intraoperative navigation is associated with a short learning curve and a minimal increase in operative time. Nevertheless, further research is necessary to substantiate the clinical benefit of navigation and evaluate its economic cost-effectiveness and impact on implant survival. Augmented reality and robotic-assisted surgery are additional emerging technologies that, while novel, hold the potential to further advance the field of shoulder arthroplasty.
6.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
Clinics in Orthopedic Surgery 2024;16(5):679-687
Intraoperative navigation is a novel technology that can provide real-time feedback to the surgeon during implantation and enhance the accuracy and precision of glenoid component positioning. Applications of intraoperative navigation systems have demonstrated increased precision in baseplate version and inclination, as well as improved baseplate screw placement, with fewer screws used and greater purchase length achieved when compared to standard instrumentation. Early clinical studies have shown favorable results, with significantly improved patient-reported and clinical outcomes and decreased complications. The implementation of intraoperative navigation is associated with a short learning curve and a minimal increase in operative time. Nevertheless, further research is necessary to substantiate the clinical benefit of navigation and evaluate its economic cost-effectiveness and impact on implant survival. Augmented reality and robotic-assisted surgery are additional emerging technologies that, while novel, hold the potential to further advance the field of shoulder arthroplasty.