Improved accuracy of glenoid positioning in total shoulder arthroplasty with intraoperative navigation: a prospective-randomized clinical study

J Shoulder Elbow Surg. 2009 Jul-Aug;18(4):515-20. doi: 10.1016/j.jse.2009.03.014.


Hypothesis: The correct implantation of the glenoid component is of paramount importance in total shoulder arthroplasty (TSA). We hypothesized that the accuracy of the glenoid positioning in the transverse plane can be improved using intraoperative navigation.

Materials and methods: This prospective, randomized clinical study comprised 2 groups of 10 patients each with osteoarthritis of the shoulder TSA, with or without intraoperative navigation. Glenoid version was measured on axial computed tomography scans preoperatively and 6 weeks postoperatively.

Results: The operating time was significantly longer in the navigation group (169.5 +/- 15.2 vs 138 +/- 18.4 min). We found an average change of retroversion from 15.4 degrees +/- 5.8 degrees (range, 3.0 degrees -24.0 degrees) preoperatively to 3.7 degrees +/- 6.3 degrees (range, -8.0 degrees to 15.0 degrees) postoperatively in the navigation group compared with 14.4 degrees +/- 6.1 degrees (range, 2.0 degrees -24.0 degrees) preoperatively to 10.9 degrees +/- 6.8 degrees (range, 0.0 degrees -19.0 degrees) postoperatively in the group without navigation (P = .021).

Conclusion: We found an improved accuracy in glenoid positioning in the transverse plane using intraoperative navigation. The validity of the study is limited by the small number, which advocates continuation with more patients and longer follow-up.

Level of evidence: Level 2; Therapeutic study.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Arthroplasty, Replacement / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Prosthesis
  • Male
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Osteoarthritis / diagnosis
  • Osteoarthritis / surgery*
  • Probability
  • Range of Motion, Articular / physiology*
  • Recovery of Function
  • Risk Assessment
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • Surgery, Computer-Assisted / methods*
  • Treatment Outcome