• Philipp Kriechling, Rafael Loucas, Marios Loucas, Fabio Casari, Philipp Fürnstahl, and Karl Wieser.
• Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland. philipp.kriechling@balgrist.ch.
• Arch Orthop Trauma Surg. 2023 Jan 1; 143 (1): 169175169-175.

BackgroundTo achieve an optimal clinical outcome in reverse total shoulder arthroplasty (RSA), accurate placement of the components is essential. The recently introduced navigation technology of augmented reality (AR) through head-mounted displays (HMD) offers a promising new approach to visualize the anatomy and navigate component positioning in various orthopedic surgeries. We hypothesized that AR through HMD is feasible, reliable, and accurate for guidewire placement in RSA baseplate positioning.MethodsTwelve human cadaver shoulders were scanned with computed tomography (CT) and RSA baseplate positioning was 3-D planned using dedicated software. The shoulders were prepared through a deltopectoral approach and an augmented reality hologram was superimposed using the HMD Microsoft HoloLense. The central guidewire was then navigated through the HMD to achieve the planned entry point and trajectory. Postoperatively, the shoulders were CT-scanned a second time and the deviation from the planning was calculated.ResultsThe mean deviation of the entry point was 3.5 mm  ± 1.7 mm (95% CI 2.4 mm; 4.6 mm). The mean deviation of the planned trajectory was 3.8°  ± 1.7° (95% CI 2.6°; 4.9°).ConclusionAugmented reality seems feasible and reliable for baseplate guidewire positioning in reverse total shoulder arthroplasty. The achieved values were accurate.© 2021. The Author(s).

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