Intraoperative navigation and preoperative templating software are associated with increased glenoid baseplate screw length and use of augmented baseplates in reverse total shoulder arthroplasty

Abstract

Background: Preoperative templating software and intraoperative navigation have the potential to impact baseplate augmentation utilization and increase screw length for baseplate fixation in reverse total shoulder arthroplasty (rTSA). We aimed to assess their impact on the (1) baseplate screw length, (2) number of screws used, and (3) frequency of augmented baseplate use in navigated rTSA. Methods: We compared 51 patients who underwent navigated rTSA with 63 controls who underwent conventional rTSA at a single institution. Primary outcomes included the screw length, composite screw length, number of screws used, percentage of patients in whom 2 screws in total were used, and use of augmented baseplates. Results: Navigation resulted in the use of significantly longer individual screws (36.7 mm vs. 30 mm, P < .0001), greater composite screw length (84 mm vs. 76 mm, P = .048), and fewer screws (2.5 ± 0.7 vs. 2.8 ± 1, P = .047), as well as an increased frequency of using 2 screws in total (35 of 51 patients [68.6%] vs. 32 of 63 controls [50.8%], P = .047). Preoperative templating resulted in more frequent augmented baseplate utilization (76.5% vs. 19.1%, P < .0001). Conclusion: The difference in the screw length, number of screws used, and augmented baseplate use demonstrates the evolving role that computer navigation and preoperative templating play in surgical planning and the intraoperative technique for rTSA.

Keywords

• Computer navigation
• reverse total shoulder arthroplasty
• glenoid
• screw length
• baseplate fixation
• baseplate augmentation