Clinical Use of a Computer Assisted Anatomic Total Shoulder Arthroplasty System: An Analysis of 574 Cases

Accurate reproduction of glenohumeral anatomy during anatomic total shoulder arthroplasty (aTSA) has been shown to correlate with positive clinical outcomes. Preoperative planning and computer assisted surgery (CAS) can improve upon glenoid placement, but such systems for aTSA have experienced limited commercial success. Postoperative surgical reports from the first 574 clinical cases of a commercially available CAS aTSA system were collected and analyzed for implant selection, implant placement, and incision start to incision close operative time, and compared to similar date cohorts for non-navigated cases. Navigated aTSA cases had a significantly longer incision time than non-navigated cases. Augmented glenoid components were used in a much higher percentage of navigated cases than non-navigated cases, suggesting that augmented glenoid components provide utility for correcting pathologic glenoid wear. The average resultant version of the implanted component increased with the size of augment used, suggesting there may not be a clear consensus on optimal retroversion. term clinical follow up will need to be collected to determine if preoperative planning combined with more precise and accurate glenoid component positioning leads to improved clinical outcomes and implant longevity.