Rates of reverse total shoulder arthroplasty (rTSA) continue to grow. Glenoid bone loss and deformity remains a technical challenge to the surgeon and may reduce improvements in patients’ outcomes. However, there is no consensus as to the optimal surgical technique to best reconstruct these patients’ anatomy. This review aims to compare the outcomes of glenoid bone grafting versus augmented glenoid prostheses in the management of glenoid bone loss in primary reverse total shoulder arthroplasty. This systematic review and meta-analysis evaluated study-level data in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We performed searches of Medline (Ovid), Embase (Ovid), and PubMed from their dates of inception to January 2022. From included studies, we analyzed data for preoperative and postoperative range of motion (ROM), patient-reported functional outcomes, and complication rates.Aims
Methods
The need for regeneration and repair of bone presents itself in a variety of clinical situations. The current gold standard of treatment is autograft harvested from the iliac crest or local bone. Inherent disadvantages associated with the use of autogenous bone include limited supply, increased operating time and donor site morbidity. This study utilized a challenging model of posterolateral fusion to evaluate the in vivo response of an engineered collagen carrier combined with nano-structured hydroxyapatite (NanOss Bioactive 3D, Pioneer Surgical) compared to a collagen porous beta-tricalcium phosphate bone void filler (Vitoss BA, Orthovita). A single level posterolateral fusion was performed in 72 adult rabbits at 6, 12 and 26 weeks (8 per group per time point). Group 1: nanOss Bioactive 3D + bone marrow aspirate (BMA) + autograft, Group 2: Vitoss BA + BMA and Group 3: Autograft + BMA were compared were compared using radiographic (X-ray and Micro-computed tomography (μCT), biomechanics (manual palpation and tensile testing at 12 and 26 weeks) and histology.Introduction
Materials and Methods
The marriage of rapid prototyping technologies with Arthroplasty has resulted in the fabrication and use of cutting jigs and guides which are tailored to a patients' individual anatomy. These disposable cutting blocks are designed based on input parameters obtained from pre-operative CT and MRI scans and manufactured using 3-D printers. Indirect benefits include a reduction in inventory and a decrease in the burden for central sterilising units. This approach is advantageous for the surgeon in the attainment of ideal mechanical alignment, which is known to be associated with an improved clinical outcome and implant longevity. This study evaluated the postoperative alignment parameters from a single surgeon series of patients following TKA with the Signature (Biomet) system. The postoperative alignment of a single surgeon series of 60 consecutive patients receiving a Vanguard cruciate retaining TKR (Biomet) using the Signature patient-specific surgical positioning guides was performed. Postoperative CT and preoperative templating MRI scans were imported into Mimics 14.0 (Materialise, Belgium) where specific bony landmarks were identified in both data sets. A subset of these points was used to transform the MRI data into the CT coordinate frame to enable the computation of femoral mechanical alignment in the absence of a full-length lower limb CT scan. CT and transformed MRI landmarks were then imported into ProEngineer (PTC, MA) where angular measurements were made by projecting axes onto anotomical planes. Flexion, rotation, valgus/varus of the femoral component and posterior slope, rotation and valgus/varus of the tibial component were computed. Femoral rotation was referenced to the trans-epicondylar axis as opposed to Whiteside's line. Overall limb alignment was determined based on individual component position.Introduction
Methods and Materials
