Issue link: https://viewer.e-digitaledition.com/i/970884
TOTAL SHOULDER REPL ACEMENT IS A CHALLENGING BUT VERY SUCCESSFUL SURGERY. OUTCOMES ARE IMPROVED BY PICKING A SURGEON AND A HOSPITAL THAT PERFORMS A HIGH VOLUME OF TOTAL SHOULDER REPL ACEMENTS, BUT E VEN HIGH VOLUME SURGEONS CAN IMPROVE THEIR OUTCOMES. SOME OF THE SAME TECHNOLOGY THAT HELPS YOU NAVIGATE WHILE DRIVING CAN HELP A SURGEON IMPROVE THE PL ACEMENT AND OUTCOMES OF A TOTAL SHOULDER SURGERY. SHOULDER SURGEONS HERE AT CRYSTAL CLINIC ORTHOPAEDIC CENTER ARE USING THIS TECHNOLOGY TO IMPROVE THEIR PATIENTS' SHOULDER REPL ACEMENT SURGERY. AT THE END of last year, ExactechGPS® released their navigation system that helps a surgeon bet ter understa nd a pat ient 's a nat omy pr ior t o su rger y. Essentially, I am able to do a "virtual" shoulder replacement on my patient before actually taking them to the operat- ing room. To begin, the patient obtains a specific CT scan of their shoulder. From this, the software program creates a 3-D model of the scapula that allows me to identify any cha llenges based on their specific a natomy. On my computer, I a m able to do a vir tua l surger y, selecting a nd tria ling a ll my implant options before choosing the best one and its best posi- tion for my patient. This virtual surgery is saved and loaded into the system on the day of surger y. During the actua l surgery, a special monitor and innovative instrumentation provide me live GPS feedback to place the rea l component in exactly the same position as on my virtual surgery. Other companies have technology to help surgeons plan a total shoulder surgery, but this is currently the only system that provides live feedback during the surgery to ensure accurate placement of the implant. By improving the positioning of the components during surgery and inserting them into the best possible bone for the patient, we should see improved longevity of the total shoulder replacement. Also, refining the positioning of the shoulder replacement to better recreate a patient's normal anatomy should enhance motion and function. Not every patient considering a total shoulder or a reverse total shoulder needs to use this technology. Patients who may benef it the most from GPS pla nning a re those whose glenoid (the socket) is ex tremely sma ll or whose bone has been excessively or a sy m metr ica l ly eroded from severe arthritis or previous fracture. If a patient has severe glenoid wear or a difficult glenoid, traditiona l tota l shoulder or reverse tota l shoul- der replacement surgery is much more challenging. You'll want to discuss your specific condition with your surgeon to determine if you're a candidate for the ExactechGPS surgery. Dr. Curtis Noel is a board-certified, fellowship-trained orthopaedic surgeon and a member of the American Shoulder and Elbow Society. He specializes in shoulder and elbow surgery and sports medicine at Crystal Clinic where he per- formed nearly 300 shoulder replacement surgeries last year. n GPS TECHNOLOGY Is Improving Shoulder Surgery BY CURTIS NOEL, MD 1 2