Navigation in Shoulder Replacement Surgery
Hi, my name is Gavin Jennings and today we’ll be doing a reverse shoulder replacement using the Equinoxe Navigated shoulder system and here you can see the patient’s radiographs.
The instrumentation for the procedure is exactly the same; the only extra tray for navigation is this one. You can see we have planned for a superior augment. This corrects the angulation and preserves bone stock. We figured that with a standard base plate we’d need to remove at least 4mm of inferior bone to get decent contact with the back of the base plate. What we will hopefully end up with if we rotate it is good contact, reasonably little superior tilt, very little over-hang and adequate bone stock for good fixation and there is no perforation front or back with the peg.
In terms of the initial set up, we need to ensure that the navigation screen and sensor has an unobscured view of the sensor we will subsequently place in the coracoid of the patient. Here we’ve got a sterile drape over the screen so I touch that if necessary. And now you can see we are using the Navigation to help us insert the guide wire, not only with the correct entry point, but also in the correct version and tilt. Now having reamed the glenoid we are using the navigation again to help us drill the central peg hole in exactly the desired orientation. This is probably the most useful part of the navigation because we are using it to give us real time information on exactly where we are drilling into the bone as we go and we can make adjustment to get maximum screw length for fixation of the glenoid.