Surgical Planning in Shoulder Prostheses with 3D Reconstruction and Customized 3D Guides

摘要

To date, all primary shoulder prostheses, as well as any other joint, were made with standard metallic instruments for all types of patients, said instruments have great deficiencies since they were developed to cover all types of surgeries, with the great variety of bone sizes of patients, types of approaches (method to get to the bone, separating and respecting skin, muscles, vascular and nervous package, facias), etc. In addition to all this, each surgeon has specific surgical techniques, and for all of them, the standard guides of the instruments have deficiencies in terms of the complexity of their application, sizes, etc. With the current diagnostic elements, surgeons are perfectly aware of the patient's pathology, but new 3D planning techniques offer surgeons knowledge of the anatomy of each bone, as well as its disposition in space, due to the deformities that occur in joints due to osteoarthritis and different degenerative pathologies. This is of great help to be able to plan the placement of the surgical implant and in this way, the height and angulation of the osteotomy (cutting line perpendicular to the bone). With this technology we are raising the quality of prosthetic implant surgery to a higher level, since the surgeon knows in advance perfectly the state of each joint, the anatomical shape of each bone due to the deformities that it suffers, and knows in advance how the prosthesis is implanted, at your discretion. This has not happened to date, since before the existence of 3D reconstruction and surgical planning, the surgeon presented blindly to the surgeries. Another field of application very important for this technology, are the tumor prostheses. Thanks to PET-CT (positron emission tomography), which delimits the tumor three-dimensionally in space with respect to bone with different degrees of malignancy that are classified according to SUV value. Thanks to 3D reconstruction and surgical planning, we can perform more advanced tumor surgery.