Abstract
AIMS: Augmented Reality (AR) guidance has demonstrated improved accuracy in glenoid component placement in both in-vitro and in-vivo settings. In cases of severe glenoid wear, structural bone may allow for defect correction. This study evaluates the accuracy of glenoid component positioning and graft incorporation in angled bony-increased offset reverse shoulder arthroplasty (BIO-RSA) assisted by navigated AR. METHODS: Fifteen shoulders with severe glenoid erosion underwent angled BIO-RSA between 2021 and 2023. Preoperative computed tomographic (CT) scans facilitated three-dimensional (3D) surgical planning. Intraoperatively, glenoid placement was guided by navigated AR. Postoperative CT scans at six months were analyzed for graft incorporation and compared with preoperative planning to assess implant positioning accuracy. RESULTS: The mean deviation between preoperative planning and postoperative positioning was 4.1° ± 3.4° (range, 0°-11°) in baseplate version and 1.9° ± 2.4° (range, 0°-9°) in inclination. Baseplate entry-point deviation was 1.6 mm ± 1.2 mm (range, 0.5-4.0 mm) in the antero-posterior direction and 1.1 mm ± 1.1 mm (range, 0-4.5 mm) in the superior-inferior direction. The mean deviation in baseplate offset reconstruction was 2.1 mm ± 1.6 mm (range, 0-5.5 mm). Complete graft incorporation was observed in all cases. CONCLUSION: Navigated AR enhances precision in BIO-RSA, ensuring accurate correction of glenoid wear and adherence to preoperative 3D planning. LEVEL OF EVIDENCE: Retrospective radiological study.