Patient-Matched Implementation for Reverse Total Shoulder Arthroplasty.

Abstract

Three-dimensional (3D) preoperative planning and patient-specific instrumentation (PSI) improve accuracy of glenoid component implantation in reverse shoulder arthroplasty. Use a 3D software tool for virtual preoperative planning of glenoid component implantation. Place the patient in a semi-beach-chair position and perform a standard deltopectoral approach. Prepare the humeral side for implantation of the humeral component using standard instrumentation. Expose the glenoid and prepare the glenoid surface for component implantation. Use the 4 PSI guides to prepare the glenoid for component implantation according to the preoperative plan. Implant the glenosphere and humeral component and reduce the prosthesis. Start passive and active-assisted exercises immediately, and begin muscle strengthening and active exercises at 6 weeks. A recent prospective, comparative study assessed the influence of 3D preoperative planning and PSI guidance of glenoid component positioning in total shoulder arthroplasty and reverse shoulder arthroplasty¹⁸.