Partial Shoulder Arthroplasty Guided by Three-dimensional Prototyping

Three-dimensional (3D) printing technology is a reality in medicine. In Orthopedics and Traumatology, 3D printing guides a precise and tailored surgical treatment. Understanding and disseminating its applicability, use, and outcomes can foster academicism and improve patient care. This is a report of a rare case of a female young adult patient with osteonecrosis of the humeral head due to avascular necrosis developed in early childhood. The treatment was tailored and optimized with 3D printing, which helped determine the steps for partial humeral arthroplasty.

Keywords
arthroplasty, replacement, shoulder; shoulder joint; three-dimensional imaging; three-dimensional printing

Authorship

Lucas Maia Address for correspondence Lucas Maia, Rua Dom Paulo de Tarso Campos, 234-354, Parque dos Jacarandás, Campinas, São Paulo, Brazil (e-mail: maia1505@gmail.com).

Division of Shoulder and Elbow Surgery, Pontifícia Universidade Católica de Campinas (PUC), Campinas, São Paulo BrazilPontifícia Universidade Católica de CampinasBrazilCampinas, São Paulo, BrazilDivision of Shoulder and Elbow Surgery, Pontifícia Universidade Católica de Campinas (PUC), Campinas, São Paulo Brazil

https://orcid.org/0000-0002-1502-0069

Kennedy Tavares Ladeia

https://orcid.org/0000-0001-5729-7368

Bernardo Figueira Althoff

Division of Hand Surgery, Pontifícia Universidade Católica de Campinas (PUC), Campinas, São Paulo, BrazilPontifícia Universidade Católica de CampinasBrazilSão Paulo, BrazilDivision of Hand Surgery, Pontifícia Universidade Católica de Campinas (PUC), Campinas, São Paulo, Brazil

https://orcid.org/0000-0002-9190-7833

Adriano Marchetto

Division of Shoulder and Elbow Surgery, Instituto Wilson Mello, Campinas, São Paulo, BrazilInstituto Wilson MelloBrazilSão Paulo, BrazilDivision of Shoulder and Elbow Surgery, Instituto Wilson Mello, Campinas, São Paulo, Brazil

https://orcid.org/0000-0003-0469-8656

Diego Meneghel

Division of Foot and Ankle Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São PauloBrazilSão Paulo, BrazilDivision of Foot and Ankle Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

https://orcid.org/0000-0001-5216-876X

Guilherme Valdir Baldo

Division of Shoulder and Elbow Surgery, Centro Universitário para o Desenvolvimento do Alto Vale do Itajaí (UNIDAVI), Rio do Sul, Santa Catarina, BrazilCentro Universitário para o Desenvolvimento do Alto Vale do ItajaíBrazilRio do Sul, Santa Catarina, BrazilDivision of Shoulder and Elbow Surgery, Centro Universitário para o Desenvolvimento do Alto Vale do Itajaí (UNIDAVI), Rio do Sul, Santa Catarina, Brazil

Address for correspondence Lucas Maia, Rua Dom Paulo de Tarso Campos, 234-354, Parque dos Jacarandás, Campinas, São Paulo, Brazil (e-mail: maia1505@gmail.com).

Conflict of Interests

The authors have no conflict of interests to declare.

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Figures

Figures (5)

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Fig. 1
Humeral head osteonecrosis: (A) progressive Creuss⁶6 Dialectos A, Namdari S. Glenohumeral osteoarthritis and the young patient: current options for treatment. Curr Orthop Pract 2017;28(02):130 stages 1) pre-radiographic stage, 2) subchondral sclerosis, 3) subchondral fracture, 4) evident head collapse, 5) degenerative changes of the head; (B) preoperative radiography; (C) computed tomography scan.

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Fig. 2
Full-size, 3D-printed prototype: (A) rear aspect; (B) lateral aspect; (C) top aspect; (D) anteromedial aspect of the humerus (post-test).

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Fig. 3
(A) Osteotomy of the humeral head and tuberosities; (B) insertion of the intramedullary nail; (C) verification of the greater tuberosity positioning; (D) post-test outcome at the proximal end of the humerus.

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Fig. 4
Immediate postoperative radiograph: (A) true anteroposterior view; (B) anteroposterior view; (C) oblique view.

Thumbnail

Fig. 5
Postoperative clinical outcomes: (A) surgical incision; (B) frontal appearance; (C) external rotation; (D) abduction; (E) hand to mouth; (F) hand to head; (G) internal rotation; (H) hand to back.

Fig. 1 Humeral head osteonecrosis: (A) progressive Creuss⁶6 Dialectos A, Namdari S. Glenohumeral osteoarthritis and the young patient: current options for treatment. Curr Orthop Pract 2017;28(02):130 stages 1) pre-radiographic stage, 2) subchondral sclerosis, 3) subchondral fracture, 4) evident head collapse, 5) degenerative changes of the head; (B) preoperative radiography; (C) computed tomography scan.

Fig. 2 Full-size, 3D-printed prototype: (A) rear aspect; (B) lateral aspect; (C) top aspect; (D) anteromedial aspect of the humerus (post-test).

Fig. 3 (A) Osteotomy of the humeral head and tuberosities; (B) insertion of the intramedullary nail; (C) verification of the greater tuberosity positioning; (D) post-test outcome at the proximal end of the humerus.

Fig. 4 Immediate postoperative radiograph: (A) true anteroposterior view; (B) anteroposterior view; (C) oblique view.

Fig. 5 Postoperative clinical outcomes: (A) surgical incision; (B) frontal appearance; (C) external rotation; (D) abduction; (E) hand to mouth; (F) hand to head; (G) internal rotation; (H) hand to back.

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Partial Shoulder Arthroplasty Guided by Three-dimensional Prototyping

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[1] Address for correspondence Lucas Maia, Rua Dom Paulo de Tarso Campos, 234-354, Parque dos Jacarandás, Campinas, São Paulo, Brazil (e-mail: maia1505@gmail.com).