Augmented reality significantly reduces the absolute error between achieved and planned inclination and version of the glenoid baseplate for reversed shoulder arthroplasty

Background

To determine whether using augmented reality with a head-mounted display (AR-HMD) would reduce deviations between planned and achieved reverse total shoulder arthroplasty (rTSA) glenoid baseplate inclination and version.

Methods

Ten fresh frozen shoulders from 5 human cadavers, which were free from fractures or other bony pathologies were used. Computed tomography scans were acquired for each shoulder, and imported into image 3-dimensional processing software to plan rTSA, and notably to define the target inclination and version of the glenoid baseplate. Two experienced surgeons placed a 1.6-mm Kirschner wire on the glenoid baseplate insertion site in each shoulder (5 per surgeon) using conventional instruments, and the AR-HMD was used to measure the inclination, version, in addition to the number of outliers. Afterward, using the AR-HMD (Pixee Medical, Besançon, France) the surgeons drilled and inserted the Kirschner wire for the glenoid baseplate positioning, and computed tomography was used to measure the inclination, version, and number of outliers.

Results

Absolute deviations between planned and achieved inclination were significantly smaller when using AR-HMD (0.9° ± 1.6°, range 0°-5°) than without AR-HMD (5.1°± 3.7°, range 0°-10°) (P = .007), and there were fewer outliers with absolute deviation when using AR-HMD (n = 1) than without using AR-HMD (n = 7). Absolute deviations between planned and achieved version were significantly smaller when using AR-HMD (0.7° ± 0.5°, range 0°-1°) than without AR-HMD (5.5° ± 4.4°, range 0°-14°) (P = .007), and there were fewer outliers with absolute deviation when using AR-HMD (n = 0) than without using AR-HMD (n = 7). Mean distance from entry point was −1.1 ± 1.7 mm in the superior–inferior axis, and 0.5 ± 0.9 mm in the anterior–posterior axis.

Conclusion

AR-HMD significantly reduces the absolute error between achieved and planned inclination and version of the glenoid baseplate during rTSA, though further studies are required to confirm the benefits of this technology in clinical settings.