Navigation-recorded plan execution in augmented total shoulder arthroplasty using the Advita GPS system and implant platform

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Background Computer-assisted navigation (CAN) is increasingly utilized in total shoulder arthroplasty (TSA), yet data validating its intraoperative agreement with preoperative plans in glenoid deformities remain limited. This study evaluated the navigation-recorded execution of the preoperative plan for glenoid entry point, version, and inclination in TSA treated with augmented glenoid components. Methods In this retrospective database study, we analyzed preoperative computed tomography and intraoperative navigation reports from 19,054 navigated TSAs performed by 871 surgeons using the Advita GPS system and implant platform. Cohorts were subdivided by glenoid retroversion (GRV) ≥15° or <15° and glenoid inclination (GI) ≥10° or <10°. Plan deviations were calculated from the navigation-recorded entry point and central drill trajectory, used as surrogates for final implant position, and compared by deformity severity and augment subtype. Results After excluding 189 cases (0.85%) with discontinued CAN, the cohort comprised 2,266 anatomic TSA (aTSA) and 16,788 reverse TSA (rTSA). In rTSA, GRV ≥15° showed marginally greater version deviation than GRV <15°, although both groups remained approximately 0.3° from plan (P=.006). Entry point deviations were statistically higher with GRV ≥15° and GI ≥10° but remained approximately 1 mm across groups (P<.001 and P=.009, respectively). Posterior augments demonstrated higher version deviation than superior augments, although both remained below 1° (P<.001). In aTSA, no subgroup differences were identified. Conclusions CAN showed close intraoperative agreement between the preoperative plan and the navigation-recorded surrogate for final implant position across augmented aTSA and rTSA, irrespective of glenoid deformity severity. Statistically significant differences remained below thresholds of clinical relevance. Level of Evidence Level III, Retrospective Cohort Comparison using Large Database, Treatment Study.

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