Arthroscopic Glenohumeral Arthrodesis With O-Arm Navigation

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Presentation transcript:

Arthroscopic Glenohumeral Arthrodesis With O-Arm Navigation Alexandre Lädermann, M.D., Patrick J. Denard, M.D. Arthroscopy Techniques Volume 3, Issue 2, Pages e205-e209 (April 2014) DOI: 10.1016/j.eats.2013.09.020 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 Right shoulder with anterior viewing portal and posterior working portal. Because of the degree of bone loss, the glenoid is prepared with microfracture only to avoid further bone loss. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 Intraoperative photograph of right shoulder. Before O-arm navigation, a fixed reference with reflective marker spheres is placed on the spine of the scapula. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 Photograph showing acquisition of intraoperative computed tomography scan obtained with O-arm. The scan is used to plan the position of the screws. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 Photographs showing (A) placement of guidewires in glenohumeral joint with (B) guidance of intraoperative computer-assisted navigation. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 Postoperatively, the patient is immediately immobilized with a humeral abduction sling. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 (A) A preoperative anteroposterior radiograph of the right shoulder shows severe medialization of the humeral head and a laterally down-sloped acromion. (B) The scapular-Y view shows posterior subluxation of the humeral head relative to the glenoid. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 7 A preoperative computed tomography scan of the same patient in Fig 6 shows posterior humeral head subluxation, limited glenoid bone stock, and grade IV fatty infiltration of the rotator cuff and deltoid muscles. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 8 A postoperative anteroposterior radiograph 1 year after arthroscopic glenohumeral arthrodesis with O-arm navigation shows maintained integrity and position of the hardware. The arrow shows an acromiohumeral screw. A washer could have been beneficial to avoid countersinking the screw head in the soft bone. Arthroscopy Techniques 2014 3, e205-e209DOI: (10.1016/j.eats.2013.09.020) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions