Key result
Custom 3D-printed glenoid implant allows successful reverse total shoulder arthroplasty in severe post-traumatic deformation.
Why the study?
The difficulty of installing the glenoid component in total shoulder arthroplasty leads to 30–50% of mechanical complications and revision operations, motivating the use of individual 3D-printed implants and tools.
Case Report (n=1)
Individual 3D-printed glenoid implants and custom tools can facilitate reverse shoulder arthroplasty in patients with severe post-traumatic glenoid deformation.
May enable reverse arthroplasty in severe glenoid deformity; hypothesis-generating and requires prospective validation before practice change.
Total shoulder arthroplasty (anatomical or reversible) has gained considerable popularity, but the difficulty of installing the glenoid component determines the development of 30–50 % of mechanical complications and revision operations. To simplify glenoid installation, an individual tool of an unusual design is used. Objective. To show clinical case of individual modeling of a glenoid implant, made by 3D printing, for the patient with old fixed humeral dislocation. Methods. A 52-year-old patient complained of severe pain and impaired limb function 4 years after a fracture-dislocation of the left numeral head, that was not reduced. The difficulty was in the presence of a significant HillSachs impression and huge anterior glenoid defect, IV stage osteoarthritis. Results. To solve the problem, a three-dimensional modelof the scapula was built based on the results of computer tomography, and its plastic model was printed. Designed individual augment for glenosphere installation.Lateralization of the center of rotation by 5 mm and downward inclination of the glenosphere by 5° was performed in the implant. The implant stem channel and screw holes are modeled to pass through the most massive parts of the scapula. An individual tool has been developed for installing this component and drillings for the screws. During the surgical intervention, the prepared tools and implant allowed to install a revers total shoulder implant and obtain the nearest positive result. Conclusions. It is advisable to use three-dimensional modelling with 3D printing in cases of reversible shoulder arthroplasty for patients with old fixed humeral dislocation and significant glenoid defect.
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Golovakha et al. (2022) conducted a case report in Old fixed humeral dislocation with significant glenoid defect and IV stage osteoarthritis (n=1). Individual modeling of a glenoid implant made by 3D printing was evaluated on Successful installation and nearest positive result. Three-dimensional modeling and 3D printing of an individual glenoid implant allowed for successful reverse total shoulder arthroplasty in a patient with severe post-traumatic glenoid deformation.
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