Dr. Kirk Reynolds recently performed an innovative shoulder procedure – the first in the state of Arkansas – utilizing 3D CT imaging that translated into a custom-made guide for total shoulder replacement surgery.
The procedure, which uses a 3D custom guide that is made from a CT scan of the patient’s shoulder, helps eliminate potential errors that can cause a total shoulder replacement to fail.
Reynolds explains that the most common reason the traditional method of surgery is not successful is that the new socket may not be perfectly matched, and 1) it could start to loosen, which increases the risk of dislocation, or 2) most commonly, the plastic wears out before it should.
Essentially, in a total shoulder replacement, the surgeon resurfaces the socket with a thin piece of plastic. The socket surface is only a half dollar in size, so when the surgeon drills a hole into the center of the socket to position the component, he has to eyeball it in an attempt to get the pin in exactly dead center.
“It is virtually impossible to get it perfect every single time,” says Dr. Reynolds. “This new procedure decreases the risk of getting off the mark – of human error in one-dimensional procedures – because it recreates the patient’s anatomy using 3D technology.”
Dr. Reynolds works with Biomet – currently the only company in the United States to offer this type of patient-matched implant. First, a patient’s CT scan is sent back to Biomet’s lab in Indiana. Three to four weeks later, Dr. Reynolds gets an email with a 3D image of the shoulder blade, superimposed where the plastic should sit. Dr. Reynolds can adjust if necessary, then approves. All of this is via email. A week to 10 days later, Dr. Reynolds gets a 3D model with a custom guide that fits to the patient’s shoulder blade and snaps onto the socket. In surgery, Dr. Reynolds drills the pin through the hole, and the pin will be dead center.
Though Dr. Reynolds has only performed two of these procedures so far, he already sees numerous benefits.
“In addition to decreasing error, it’s also less stressful in the operating room and, so far, has saved about 45 minutes of surgery time,” he explains.
He hopes the technology will continue to catch on and be approved by more insurance companies and hospitals.
“I looked back at 15 total shoulder replacement cases,” he says. “They were all within the acceptable range, but it’s pretty remarkable to look at the X-rays of these cases and see the pin in dead center.”