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Background <p>Reverse shoulder arthroplasty (RSA) is a widely used procedure for glenohumeral joint degeneration. Despite advancements in 3D preoperative planning, the concordance between planned and intraoperatively implanted components remains unclear. This study evaluates the accuracy of 3D preoperative planning in predicting humeral and glenoid components size in RSA with a 135° neck-shaft angle (NSA) short-stem.</p> Materials and methods <p>A retrospective study was conducted on 84 RSA cases performed between October 2023 and September 2024 at a specialized shoulder surgery center. All cases underwent standardized preoperative imaging, including anteroposterior and axillary radiographs and a 3D CT scan-based planning protocol using BluePrint software. The planned and intraoperatively implanted humeral stems, glenoid baseplates, and glenospheres were compared. Statistical analyses were performed to assess concordance in term of size and identify factors influencing deviations from the preoperative plan.</p> Results <p>The preoperative plan was fully respected in 23.1% of cases for both the humeral and glenoid components. The humeral stem size matched the preoperative plan in 28.6% of cases, with a deviation within one adjacent size in 67.9%. The glenoid baseplate size was concordant in 92.6%, while the glenosphere size matched in 60.7%. Kappa values indicated slight agreement for stem size (κ = 0.12) and moderate agreement for glenosphere size (κ = 0.54). A statistically significant correlation was observed between changes in humeral stem and glenosphere size (<i>p</i> &lt; 0.05). No significant correlation was found with patient age, while sex significantly influenced stem and glenosphere size variation (<i>p</i> &lt; 0.05).</p> Conclusion <p>3D preoperative planning demonstrated moderate to high accuracy for glenoid component selection but lower concordance for humeral stem size. Intraoperative adjustments were mainly related to metaphyseal bone quality and soft tissue tension. Future improvements in planning software should incorporate bone mineral density and humeral osteotomy variability to enhance predictive accuracy.</p>

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Accuracy in predicting 135° neck-shaft angle short-stem and glenoid components size in reverse shoulder arthroplasty with 3D preoperative planning

  • 期刊论文

  • 发表日期：

    2026年1月3日

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  • Alessandro Donà,
  • Rocco Bonfatti,
  • Gian Mario Micheloni,
  • Andrea Giorgini,
  • Davide Basile,
  • Anna Pirozzi,
  • Giuseppe Porcellini

摘要

Background

Reverse shoulder arthroplasty (RSA) is a widely used procedure for glenohumeral joint degeneration. Despite advancements in 3D preoperative planning, the concordance between planned and intraoperatively implanted components remains unclear. This study evaluates the accuracy of 3D preoperative planning in predicting humeral and glenoid components size in RSA with a 135° neck-shaft angle (NSA) short-stem.

Materials and methods

A retrospective study was conducted on 84 RSA cases performed between October 2023 and September 2024 at a specialized shoulder surgery center. All cases underwent standardized preoperative imaging, including anteroposterior and axillary radiographs and a 3D CT scan-based planning protocol using BluePrint software. The planned and intraoperatively implanted humeral stems, glenoid baseplates, and glenospheres were compared. Statistical analyses were performed to assess concordance in term of size and identify factors influencing deviations from the preoperative plan.

Results

The preoperative plan was fully respected in 23.1% of cases for both the humeral and glenoid components. The humeral stem size matched the preoperative plan in 28.6% of cases, with a deviation within one adjacent size in 67.9%. The glenoid baseplate size was concordant in 92.6%, while the glenosphere size matched in 60.7%. Kappa values indicated slight agreement for stem size (κ = 0.12) and moderate agreement for glenosphere size (κ = 0.54). A statistically significant correlation was observed between changes in humeral stem and glenosphere size (p < 0.05). No significant correlation was found with patient age, while sex significantly influenced stem and glenosphere size variation (p < 0.05).

Conclusion

3D preoperative planning demonstrated moderate to high accuracy for glenoid component selection but lower concordance for humeral stem size. Intraoperative adjustments were mainly related to metaphyseal bone quality and soft tissue tension. Future improvements in planning software should incorporate bone mineral density and humeral osteotomy variability to enhance predictive accuracy.