Improving outcomes in shoulder arthroplasty: A case series on the GPS-navigated bulk humeral autograft technique.

Abstract

Background: The purpose of this case series is to evaluate the efficacy and safety of the GPS-navigated humeral head (HH) autograft technique in the setting of primary reverse total shoulder arthroplasty (rTSA) for severe glenoid bone loss.

Methods: A database of prospectively enrolled patients was reviewed to identify patients who underwent GPS navigated primary rTSA with HH autograft (N = 8). Variables collected pre-operatively and at last follow up included demographics, active range of motion (ROM), patient reported outcome measures radiographic measures, complications, and revisions.

Results: Mean age was 59.5 (range: 45-80), mean BMI was 26.8 (range: 18-37) and 5 patients were male. At final follow up (median: 24 months), patients had a mean increase in forward flexion of 44 (p = 0.003), external rotation of 27 (p = 0.039), internal rotation score of 1.1 (p = 0.048), global function score of 4.8 (p < 0.001), American Shoulder and Elbow Surgeons score of 44 (p < 0.001), and decrease in visual analog scale pain of 5 (p < 0.001). Two patients had evidence of glenoid component loosening at 3 years post-operatively, however only one was symptomatic requiring a revision operation.

Discussion: Our findings demonstrate significant improvement in ROM, pain relief, and shoulder function following GPS-navigated primary rTSA with bulk HH autograft.

Level of evidence: IV.