Accuracy of patient-specific guided glenoid baseplate positioning for reverse shoulder arthroplasty.

BACKGROUND: The accuracy of reproducing a surgical plan during shoulder arthroplasty is improved by computer assistance. Intraoperative navigation, however, is challenged by increased surgical time and additional technically difficult steps. Patient-matched instrumentation has the potential to reproduce a similar degree of accuracy without the need for additional surgical steps. The purpose of this study was to examine the accuracy of patient-specific planning and a patient-specific drill guide for glenoid baseplate placement in reverse shoulder arthroplasty. METHODS: A patient-specific glenoid baseplate drill guide for reverse shoulder arthroplasty was produced for 14 cadaveric shoulders based on a plan developed by a virtual preoperative 3-dimensional planning system using thin-cut computed tomography images. Using this patient-specific guide, high-volume shoulder surgeons exposed the glenoid through a deltopectoral approach and drilled the bicortical pathway defined by the guide. The trajectory of the drill path was compared with the virtual preoperative planned position using similar thin-cut computed tomography images to define accuracy. RESULTS: The drill pathway defined by the patient-matched guide was found to be highly accurate when compared with the preoperative surgical plan. The translational accuracy was 1.2 ± 0.7 mm. The accuracy of inferior tilt was 1.2° ± 1.2°. The accuracy of glenoid version was 2.6° ± 1.7°. CONCLUSION: The use of patient-specific glenoid baseplate guides is highly accurate in reproducing a virtual 3-dimensional preoperative plan. This technique delivers the accuracy observed using computerized navigation without any additional surgical steps or technical challenges.

Bone morphogenic protein: an elixir for bone grafting--a review.

Bone morphogenetic proteins (BMPs) are multifunctional growth factors that belong to the transforming growth factor beta superfamily. This literature review focuses on the molecular biology of BMPs, their mechanism of action, and subsequent applications. It also discusses uses of BMPs in the fields of dentistry and orthopedics, research on methods of delivering BMPs, and their role in tissue regeneration. BMP has positive effects on bone grafts, and their calculated and timely use with other growth factors can provide extraordinary results in fractured or nonhealing bones. Use of BMP introduces new applications in the field of implantology and bone grafting. This review touches on a few unknown facts about BMP and this ever-changing field of research to improve human life.

The role of modularity in primary total hip arthroplasty.

A combined series of 795 primary SROM (DePuy, Warsaw, Ind) stems have been reviewed. The mean follow-up is 11 years; 2 (0.25%) were revised for aseptic stem loosening. Two (0.25%) cases of osteolysis distal to the sleeve occurred, 1 of which was revised. The low incidence of distal osteolysis and aseptic loosening justifies the continued use of this stem in primary total hip arthroplasties.