Assessment of Inter- and Intrasurgeon Variability in Preoperative Planning of Reverse Shoulder Arthroplasty: A Multicenter Evaluation

Abstract

Objective To evaluate the intra and intersurgeon variability regarding the positioning and selection of implants in reverse shoulder arthroplasty.

Methods A cross-sectional study assessed computed tomography images of the shoulder joint of patients diagnosed with degenerative joint diseases. The study team included seven specialists in shoulder surgery, representing six different institutions. Surgeons were instructed to plan all cases twice, and then we evaluated inter- and intrasurgeon variability.

Results The interclass correlation for version and inclination showed low agreement concerning inclination (0.26), and moderate agreement for version (0.73) and graft selection (0.54). The intrasurgeon evaluation revealed a moderate correlation for version (0.55), inclination (0.58), and implant selection (0.46), while for lateralization the correlation was high (0.77).

Conclusion This comparative study of preoperative planning by different surgeons showed the lack of consensus on implant positioning parameters during reverse shoulder arthroplasty planning. However, most surgeons tend to plan for zero degrees of version and inclination.

Keywords

arthroplasty, replacement, shoulder/methods - observer variation - shoulder joint/surgery - software

Work carried out at the Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ; the Shoulder and Elbow Surgery Service at Faculdade de Medicina do ABC, São Paulo, SP; the School of Medicine of Universidade de São Paulo, São Paulo, SP; Instituto Naeon – Núcleo Avançado de Estudos em Ortopedia e Neurocirurgia, São Paulo, SP; and Hospital da Força Aérea do Galeão (HFAG), Rio de Janeiro, RJ, Brazil.

Publication History

Received: 10 January 2024

Accepted: 23 June 2024

Article published online:
16 August 2024

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