Baseplate fixation in reverse shoulder arthroplasty: influence of intraoperative guidance on postoperative outcomes

In reverse total shoulder arthroplasty, precise positioning of the glenoid baseplate is essential for optimizing biomechanics and implant longevity. This narrative review introduces modern guidance modalities (patient-specific instrumentation, computer-assisted navigation, and augmented reality intraoperative navigation) and compares available literature on implant alignment accuracy, patient-reported outcomes, and complication rates. Although patient-specific instrumentation and computer-assisted navigation consistently improve alignment with preoperative plans and reduce errors in guide pin and screw placement, short-term measures of strength, mobility, and patient-reported outcomes are similar to those achieved with conventional freehand methods. However, guided approaches demonstrate a reduction in the risk of complications in the short term. This suggests that the primary clinical advantage of these modern techniques is reducing complications and potentially improving long-term implant outcomes.