Proven Performance: Navigation and Real-World Results

Does GPS^® Computer Navigation result in better early outcomes compared to traditional (non-navigated) techniques?

It is well known that computer navigation can result in more accurate and precise glenoid implant placement; however, it is not well known if this better implant positioning results in improved clinical outcomes.

Holzgrefe and colleagues wanted to know if that improved accuracy and precision translates into a patient having better ranges of motion (ROM), patient reported outcome measures (PROMs) and fewer complications. They compared 113 navigated cases to 113 traditional cases to see if computer navigation provided similar clinical outcomes at least two years after reverse shoulder arthroplasty (rTSA).

• Better motion: At the final check-up, navigated patients had significantly better forward elevation (135° vs. 129°, p=0.023) and external rotation (39° vs. 32°, p=0.003) compared to non-navigated patients.
• Higher scores: The navigated group achieved significantly higher Constant scores (71.1 vs. 65.5, p=0.003) compared to non-navigated patients.
• Complication Assessment: Navigated shoulders had less complications (1.8% vs. 5.3%, p=0.28) and revisions (0.9% vs. 3.5%, p=0.37), and less scapular notching (3.1% vs. 8.0%, p=0.21), though these differences didn’t reach statistical significance in this small cohort.

Accurate baseplate fixation is a primary technical goal when performing rTSA procedures. This study suggests that navigation helps surgeons and results in patients achieving better ROMs and PROMs at short-term follow-up. These improved clinical outcomes and motion scores provide evidence that the improved accuracy/precision of GPS for baseplate placement may translate into real-world benefits for rTSA patients.

These findings are limited because they were derived from a single institution, and a longer follow-up is needed to confirm these results. Larger cohort sizes are necessary to assess low incident rate outcomes.