This walkthrough takes you through the Reverse Shoulder Arthroplasty (RSA) demo case from start to finish: creating the case, reviewing segmentation, planning the scapula and the humerus, designing the guides and approving the case. Each step has a short animation so you can follow along on your own screen.
The demo uses a sample scan and runs only in your browser session, so you can try anything without affecting real cases.
Note: Demo cases have no Save button. Your progress is kept in your current browser session only, and approving a demo case does not use a case from your organization's case allowance.
The steps at a glance
Open the demo and create the case.
Review the segmentation.
Plan the scapula: Landmarks, Surgery Planning and PSI Design.
Add the humerus and plan it the same way.
Approve the case and review the plan report.
1. Open the demo
On the home page, find Create New Case.
On the Total Shoulder Arthroplasty card, click Demo in the top-left corner. The shoulder demo is a reverse shoulder (RSA) case.
The demo opens on the case creation page with the sample scan already loaded. The Segmenting... bar at the top shows simulated segmentation progress while you fill in the case.
2. Create the case
Under Surgery Details, check the sample Surgery Date and Operational Side. The side is set by the sample scan. Click Next.
Under Case Details, the Case Output Configuration is Plan and PSI.
Click Create Case in the top-right corner. CustoMED downloads the scan files and opens Segmentation.
3. Review the segmentation
Segmentation shows the 3D model and the CT scan in four views: 3D, Axial, Coronal and Sagittal. The panel on the right lists the segmented bones, Humerus and Scapula, each on the operating side.
Hover a bone in the list to show its eye button, which hides or shows that bone.
Scroll over a CT view to move through the slices. The reference lines in the other views move with it.
Use the tools above the list to pan, zoom or change the brightness and contrast (window level) of the CT views.
Drag in the 3D view to rotate the model.
Click the expand icon in the corner of a view to make it full size. Click it again to go back to four views.
When the bones look right, click Confirm.
4. Find your way around the editor
After segmentation, the editor opens on the scapula. A few controls stay the same in every step:
The icons on the left switch between Scapula view, Humerus view and Combined view. Combined view shows both bones together. To confirm a step, switch back to a single bone.
Click the step name in the header (for example Landmarks) to open the step menu. It lists every step, and completed steps have a check mark.
The back arrow next to the main button returns to the previous step.
5. Scapula: Landmarks
CustoMED places the scapula landmarks for you. Review them before you plan.
Check Pre-Op Measurements: Superior Inclination, Retroversion and RSA Angle (with RSA and TSA values). Each name follows the direction of the value, so you may see Anteversion instead of Retroversion, for example.
Expand Scapula to see the landmark groups, such as Scapular Axis (Glenoid Center and Trigonum Scapulae), Supraspinatus fossa floor line, Glenoid Plane and Inferior Angle Of The Scapula. Click a landmark to select it in the 3D view.
Click the arrow on the right edge of the 3D view to show the CT projections (Axial, Coronal and Sagittal) next to the model.
Click Confirm Landmarks. CustoMED creates the surgery plan and opens Surgery Planning.
6. Scapula: Surgery Planning
Check Post-Op Measurements: Inclination, Version, RSA Angle, Entry Points (mm), Max Contact Length (mm) for the screw and the implant, and Implant Seating.
Use the minus and plus buttons next to a measurement to change it. The implant moves to match.
Expand the baseplate card to change the implant: Manufacturer, Sets, Type and Lateralization, then click Select Template. The card also lists the K-wire, extension, glenosphere and screws.
With the baseplate card open, use the controls around the model to move the implant (anterior, posterior, superior, inferior, lateral, medial) or rotate it.
Click Generate PSI.
7. Scapula: PSI Design
Rotate the model to look at the glenoid guide from every side.
Open the PSI type list to compare Tripod With Handle, Tripod and Tripod With Sleeve. Each type has a short description.
Expand Psi to set Additional Reinforcement and Handle Type, and to see the guide parts (Psi, Handle, Upper Leg, Middle Leg and Lower Leg).
Click Confirm PSI. CustoMED prepares the export files and opens Approve.
8. Add the humerus
Approve shows the output pack. At this point it holds the scapula plan and its PSI, and the humerus is marked Not planned. The main button reads Sign off while a bone is not planned, and Approve Case once every bone is in the pack.
Use the arrows on the preview to step through the plan and PSI previews.
Expand Files to see the Plan Report (SFU), the Delivery Note and the Case Files.
Click Add Humerus. The editor opens on the humerus Landmarks step.
9. Humerus: Landmarks
Check Pre-Op Measurements: Neck Shaft Angle, Retroversion Angle and Bicipital Groove Angle.
Expand Humerus to see Anatomical Humeral Axis, Epicondylar Axis, Bicipital Groove Line and Humeral Neck Plane. Select Humeral Neck Plane to show handles for moving and rotating the plane.
Click Confirm Landmarks.
10. Humerus: Surgery Planning
Check Post-Op Measurements: Neck Shaft Angle, Retroversion Angle, Bicipital Groove Angle and Humeral Cut Height (mm). Use the minus and plus buttons to change the neck shaft angle.
Expand the stem card to change the implant and select the Cutting Plane.
Click Generate PSI.
11. Humerus: PSI Design
Rotate the model to look at the humeral guide.
Open the PSI type list to compare Union and Minimal.
Expand Psi to see the guide parts, including the K-wires and the Cutting Blade.
Click Confirm PSI.
12. Approve the case
Check that Output Pack 1 lists both Scapula and Humerus, each with its PSI Output.
Step through the previews. Expand Post-Op Measurements under the preview to see the final values.
Click Approve Case.
Read the Responsibility Acknowledgment and click Approve & Acknowledge.
CustoMED then creates the plan report. A Generating Plan Report... bar shows the progress. Keep the tab open until it finishes.
13. After approval
The header shows Approved, and the main button changes to View Only (Approved Case).
The plan report preview appears next to the pack. Use its arrows to turn pages, or click Preview to open the full Plan Report (SFU).
Expand Files to preview the Plan Report (SFU) and the Delivery Note, or download the Case Files.
That's the whole RSA workflow. When you're ready, create a real case from the same Total Shoulder Arthroplasty card.