van den Bogaert

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

A 60-year-old woman suffering from shoulder pain and limited range of motion visited Dr. Van den Bogaert, orthopedic surgeon at AZ Herentals. After analysis of the medical images indicating a devastating shoulder arthrosis with severe medialization and complete loss of the glenoid vault, Dr. Van den Bogaert determined 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 concluded that, in this case, the 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 patient-specific solutions, Dr. Van den Bogaert contacted Materialise and worked with our clinical engineering team and 3D planning software to design a custom-made glenoid implant, based on the CT image and included a baseplate for a reverse shoulder replacement prosthesis augmented with a porous structure exactly matching the patient’s 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 was 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 custom-made titanium implant was manufactured utilizing 3D printing. Next, 3D printed, patient-specific guides were designed to guide the accurate positioning of the implant, the pre-drilling of the screw holes and the fixating of the screws during surgery. Three years after surgery, the patient is very happy with the result. She has no more pain, has regained a significantly expanded range of motion and can perform daily activities without limitations. Without a custom-made solution, it is likely this 60-year-old would still be in pain without treatment or in need of a revision surgery because of graft failure.

Enhance Patient Care with a Patient-Specific Shoulder 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 surgeons’ work. Being able to see the anatomy in 3D beforehand enables surgeons to run through a more complete planning exercise. This reduces the elements of surprise otherwise experienced in the operating room.

In addition to patient-specific implants, custom guides and bone models provide support to surgeons in the operating room. The patient-specific instruments greatly facilitate the intervention by allowing surgeons to accurately transfer the pre-operatively planned component placement and screw positioning during surgery.

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Glenius is not commercially available in the US and Canada.