[Immediate component precision and surgical safety in robot-assisted reverse shoulder arthroplasty].

Abstract

Objective: To evaluate the immediate component precision and surgical safety in robot-assisted reverse shoulder arthroplasty (RSA). Methods: A retrospective cohort study was conducted on 32 patients with proximal humeral fractures treated at the Intelligent Orthopedic Research Ward of Beijing Jishuitan Hospital, Capital Medical University between May 2023 and October 2024. The patients were divided into two groups according to surgical options: the robotic group and the conventional group. The robotic group underwent preoperative planning and glenoid baseplate positioning using the TiRobot^®, while the conventional group used standard manufacturer-provided instrumentation. Postoperative computed tomography (CT) scans were analyzed via the Picture Archiving and Communication System (PACS) to measure angular deviations (anteversion and inferior tilt) of the glenoid baseplate relative to preoperative plans. Operative time, intraoperative blood loss, and complications were compared between two groups. Results: A total of 32 patients were included, with 15 in the robotic group [6 males, 9 females, mean age: (63.1±3.1) years] and 17 in the conventional group [9 males, 8 females, mean age: (64.9±3.6) years]. No significant differences were observed between the two groups in demographics, Neer classification, or time from injury to surgery (all P>0.05). All surgeries were successfully completed without intraoperative complications. The robotic group demonstrated significantly lower angular deviations in glenoid baseplate positioning compared to the conventional group:0.77°±0.30° (anteversion) vs 3.35°±1.03° (P<0.001) and 0.81°±0.21° (inferior tilt) vs 5.14°±2.30° (P<0.001). There was no significant differences between the robotic group and the conventional group in surgical duration [(167.0±45.3) min vs (158.0±40.3) min] or intraoperative blood loss [200 (150, 200) ml vs 200 (200, 250) ml] (both P>0.05). Additionally, no surgical adverse events or related complications were observed in either group. Conclusion: Robot-assisted RSA achieves significantly higher immediate precision in glenoid baseplate positioning compared to conventional surgery, without increasing operative time, blood loss, or complication risks.