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Purpose <p>Reverse Shoulder Arthroplasty (RSA) is widely used to treat shoulder joint pathologies. However, this procedure may result in reduced range of motion (ROM), scapular notching, and prosthetic instability. These complications vary among patients, highlighting the need for individualized preoperative planning. This study introduces a novel parametric methodology to determine optimal glenoid component positioning by evaluating ROM, instability ratio, and the percentage of bone resected.</p> Method <p>The proposed approach was applied to four patient models treated with two prosthetic designs. The methodology consists of four steps within a patient-specific parametric tool: 3D anatomical reconstruction, virtual surgical planning, biomechanical and geometric evaluation, and identification of optimal configurations. Fifteen glenoid component orientations were generated by varying tilt angles. The best configurations were identified based on ROM and instability assessments, while bone resection volume was calculated as an additional parameter.</p> Results <p>Maximum values of abduction–adduction, internal rotation, and external rotation were 87.23°, 90°, and 70.59°, respectively, although not achieved in a single configuration. Instability ratios ranged from 0.23 to 0.62. Bone resection varied between 0.4% and 5.5%, depending on the configuration.</p> Conclusions <p>This methodology provides a patient-specific framework to support preoperative planning in RSA. By combining ROM analysis, instability assessment, and bone preservation, the approach enables the identification of glenoid component orientations that improve mobility while minimizing instability risk and surgical invasiveness.</p>

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Customized positioning of the glenoid component in reverse shoulder arthroplasty: a new computer aided design methodology

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月7日

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  • Antonino Cirello,
  • Tommaso Ingrassia,
  • Giuseppe Rovere,
  • Lorenzo Nalbone,
  • Lawrence Camarda,
  • Igor Agostino Mirulla,
  • Vincenzo Nigrelli,
  • Vito Ricotta,
  • Micol Tantillo

摘要

Purpose

Reverse Shoulder Arthroplasty (RSA) is widely used to treat shoulder joint pathologies. However, this procedure may result in reduced range of motion (ROM), scapular notching, and prosthetic instability. These complications vary among patients, highlighting the need for individualized preoperative planning. This study introduces a novel parametric methodology to determine optimal glenoid component positioning by evaluating ROM, instability ratio, and the percentage of bone resected.

Method

The proposed approach was applied to four patient models treated with two prosthetic designs. The methodology consists of four steps within a patient-specific parametric tool: 3D anatomical reconstruction, virtual surgical planning, biomechanical and geometric evaluation, and identification of optimal configurations. Fifteen glenoid component orientations were generated by varying tilt angles. The best configurations were identified based on ROM and instability assessments, while bone resection volume was calculated as an additional parameter.

Results

Maximum values of abduction–adduction, internal rotation, and external rotation were 87.23°, 90°, and 70.59°, respectively, although not achieved in a single configuration. Instability ratios ranged from 0.23 to 0.62. Bone resection varied between 0.4% and 5.5%, depending on the configuration.

Conclusions

This methodology provides a patient-specific framework to support preoperative planning in RSA. By combining ROM analysis, instability assessment, and bone preservation, the approach enables the identification of glenoid component orientations that improve mobility while minimizing instability risk and surgical invasiveness.