Technological innovations in shoulder arthroplasty: how does planning software work?

Both anatomic total shoulder arthroplasty and reverse shoulder arthroplasty have seen increasing utilization over the last 20 years. Malpositioned components present a significant risk for loosening and failure in both total shoulder arthroplasty and reverse shoulder arthroplasty . Preoperative planning with three-dimensional computed tomography imaging and virtual implant templating can help surgeons determine optimal implant position and has been shown to provide superior accuracy over standard 2D computed tomography imaging without virtual templating. Surgeons can use preoperative planning software to evaluate complex cases of glenoid bone loss or deformity requiring bone grafts or augmented implants to determine what surgical correction and techniques are necessary to achieve the goals of implant placement. While the development of preoperative planning software represents a technological advancement, it is important for surgeons to understand that variations can exist between different commercially available software programs in their methods of bony segmentation and landmark placement, which can lead to some differences in the measurement of pathology. This article will review how this technology is utilized to better understand preoperative bony deformity and optimize implant positioning.