van den Bogaert

Dr. Gert Van Den Bogaert,
orthopedic surgeon at
AZ Herentals, performed
the surgery.

A 60y old lady visited dr. Van den Bogaert, suffering from shoulder pain and limited range of motion. Analysis of the medical images indicated a devastating shoulder arthrosis with severe medialization and erosion of the glenoid. Due to a complete loss of the glenoid vault, implantation of a classic pegged baseplate for reverse total shoulder was not an option. In addition, because of the huge loss of bone stock and the sclerotic remaining cavity, the surgeon judged in this case that interposition of a massive bone graft would have little chance for ingrowth and survival, hence little chance to offer sufficient stability.

The value of 3D Planning and a 3D-Printed Shoulder implant

Aware of the focus on patient-specific solutions, dr. Van den Bogaert contacted Materialise. Together with a Clinical Engineer, a design process was initiated based on the CT scan to come up with a solution for this patient, matching the needs and expectations of the surgeon. A custom-made glenoid implant was designed, a baseplate for a reverse prosthesis augmented with a porous structure exactly matching the glenoid cavity. Preoperative planning included optimized position of the baseplate, to reconstruct the joint center of rotation to an anatomical position as much as possible. In addition, screw position and orientation is fully customized, to address the strongest parts of the (remaining) scapular bone.

Example of a Glenius shoulder implant model.

Example of a Glenius shoulder implant model.

Scan and analysis of the pre-operative situation

Scan and analysis of the
pre-operative situation

The titanium custom-made implant was manufactured by additive manufacturing. Next to the implant, patient-specific instruments were designed. This guides the correct positioning of the implant in surgery, the pre-drilling of the screw holes and the fixating of the screws. The guide allows for accurate positioning of the implant and provides a tool to transfer the screw planning correctly to the operating room. Three years after surgery, the patient is very happy with the result. She has no more pain and has regained a large range of motion, allowing her to fulfill her daily activities without limitations. Without a custom-made solution, this 60 year old would have remained either in pain without treatment or chances are that she would be in need for a revision surgery already because of graft failure.

Enhance Patient Care with a patient-specific hip model

Materialise offers software and services to 3D print patient-specific Glenius shoulder implants. When it comes to shoulder joint replacements, a patient-specific approach can often be more suitable than standard solutions - particularly in cases that involve severe bone defects.

Materialise Glenius offers surgeons patient-specific implants for cases of reverse shoulder arthroplasty. Our service brings predictability to your work. Being able to see the anatomy in 3D beforehand enables you to run through a more complete planning exercise. This reduces the elements of surprise you might otherwise meet in the operating room.

Next to the patient-specific implant, custom instruments and bone models are provided to support you in surgery. The patient-specific instruments greatly facilitate the intervention by allowing you to accurately transfer the pre-operatively planned component placement and screw positioning to the surgery

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