Skip to main content

Advertisement

Log in

The base of coracoid process as a reference for glenoid reconstruction in primary or revision reverse shoulder arthroplasty: CT-based anatomical study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Joint replacement surgery as a treatment for glenohumeral arthritis with glenoid bone loss is challenging. The aim of this study is to offer an anatomical orientation for glenoid reconstruction.

Methods

In this study, we measured size, inclination and version of the glenoid surface, as well as the distance between the articular line of the glenoid, base of the coracoid process, and acromion using computer tomographic (CT) imaging of 131 study participants aged 19–88 years in the period of 2010–2013.

Results

We measured a mean distance of 6.5 ± 0.2 mm from the glenoid articular line to the base of the coracoid process in the transverse CT plane. Body height has shown no significant impact on the glenoid morphology. We observed significant differences between males and females: The glenoid appeared to be located 5.2 ± 0.9 mm higher and the humeral head was 4.5 ± 0.7 mm larger in male subjects compared with females (r = .699; p < .01).

Conclusion

In our study, the base of the coracoid offers an anatomical reference during reconstruction of the glenoid in primary and revision shoulder arthroplasty. As only 2D-CT imaging allows for accurate assessment of glenoid bone defects, we consider conventional X-ray imaging insufficient for proper preoperative planning before shoulder arthroplasty.

Level of evidence

III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Boileau P, Melis B, Duperron D, Moineau G, Rumian AP, Han Y (2013) Revision surgery of reverse shoulder arthroplasty. J Shoulder Elbow Surg 22(10):1359–1370. https://doi.org/10.1016/j.jse.2013.02.004

    Article  PubMed  Google Scholar 

  2. Pascal B, Nicolas M-S, Marc-Olivier G, Seeto BL, Chalmers PN, Nicolas H, Gilles W (2017) Angled BIO-RSA (bony-increased offset-reverse shoulder arthroplasty). A solution for the management of glenoid bone loss and erosion. J Shoulder Elbow Surg 26(12):S. 2133-2142. https://doi.org/10.1016/j.jse.2017.05.024

    Article  Google Scholar 

  3. Deutsch A, Abboud JA, Kelly J, Mody M, Norris T, Ramsey ML et al (2007) Clinical results of revision shoulder arthroplasty for glenoid component loosening. J Shoulder Elbow Surg 16(6):706–716. https://doi.org/10.1016/j.jse.2007.01.007

    Article  PubMed  Google Scholar 

  4. Ernstbrunner L, Werthel J-D, Wagner E, Hatta T, Sperling JW, Cofield RH (2017) Glenoid bone grafting in primary reverse total shoulder arthroplasty. J Shoulder Elbow Surg 26(8):1441–1447. https://doi.org/10.1016/j.jse.2017.01.011

    Article  PubMed  Google Scholar 

  5. Farron A, Terrier A, Büchler P (2006) Risks of loosening of a prosthetic glenoid implanted in retroversion. J Shoulder Elbow Surg 15(4):521–526. https://doi.org/10.1016/j.jse.2005.10.003

    Article  PubMed  Google Scholar 

  6. Frankle MA, Teramoto A, Luo Z-P, Levy JC, Pupello D (2009) Glenoid morphology in reverse shoulder arthroplasty. Classification and surgical implications. J Shoulder Elbow Surg 18(6):S. 874-885. https://doi.org/10.1016/j.jse.2009.02.013

    Article  Google Scholar 

  7. Gavaskar AS, Vijayraj K, Subramanian SM (2013) Intraoperative CT navigation for glenoid component fixation in reverse shoulder arthroplasty. Indian J Orthop 47:104–106

    Article  Google Scholar 

  8. Grammont PM, Baulot E (2011) The classic. Delta shoulder prosthesis for rotator cuff rupture. Clin Orthop Related Res 469(9):S. 2424. https://doi.org/10.1007/s11999-011-1960-5

    Article  Google Scholar 

  9. Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G (2006) Reverse total shoulder arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Jt Surg Am 88(8):S. 1742-1747. https://doi.org/10.2106/JBJS.E.00851

    Article  Google Scholar 

  10. Habermeyer P, Magosch P, Lichtenberg S (2006) Three dimensional glenoid deformity in patients with osteoarthritis. A radiographic analysis. J Bone Jt Surg Am 88:1301–1307

    CAS  Google Scholar 

  11. Henninger HB, Barg A, Anderson AE, Bachus KN, Burks RT, Tashjian RZ (2012) Effect of lateral offset center of rotation in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elbow Surg 21(9):1128–1135. https://doi.org/10.1016/j.jse.2011.07.034

    Article  PubMed  Google Scholar 

  12. Hoenecke HR, Hermida JC, Flores-Hernandez C, D’Lima DD (2010) Accuracy of CT-based measurements of glenoid version for total shoulder arthroplasty. J Shoulder Elbow Surg 19(2):166–171. https://doi.org/10.1016/j.jse.2009.08.009

    Article  PubMed  Google Scholar 

  13. Jones RB, Wright TW, Roche CP (2015) Bone grafting the glenoid versus use of augmented glenoid baseplates with reverse shoulder arthroplasty. Bull Hosp Jt Dis 73(Suppl 1):S129–S135

    Google Scholar 

  14. Jean K (2012) Classifications of glenoid dysplasia, glenoid bone loss and glenoid loosening: a review of the literature. Eur J Orthop Surg Traumatol 23(3):301–310. https://doi.org/10.1007/s00590-012-1119-4

    Article  PubMed  Google Scholar 

  15. Klein SM, Dunning P, Mulieri P, Pupello D, Downes K, Frankle MA (2010) Effects of acquired glenoid bone defects on surgical technique and clinical outcomes in reverse shoulder arthroplasty. J Bone Jt Surg Am 92(5):1144–1154. https://doi.org/10.2106/JBJS.I.00778

    Article  Google Scholar 

  16. Lädermann A, Williams MD, Melis B, Hoffmeyer P, Walch G (2009) Objective evaluation of lengthening in reverse shoulder arthroplasty. J Shoulder Elbow Surg 18(4):588–595. https://doi.org/10.1016/j.jse.2009.03.012

    Article  PubMed  Google Scholar 

  17. Lévigne C, Boileau P, Favard L, Garaud P, Molé D, Sirveaux F, Walch G (2008) Scapular notching in reverse shoulder arthroplasty. J Shoulder Elbow Surg 17(6):925–935. https://doi.org/10.1016/j.jse.2008.02.010

    Article  PubMed  Google Scholar 

  18. Lévigne C, Franceschi J (1999) Rheumatoid arthritis of the shoulder: radiological presentation and results of arthroplasty. In: Walch G, Boileau P (eds) Shoulder arthroplasty. Springer, Berlin, pp 221–230

    Chapter  Google Scholar 

  19. Martin SD, Zurakowski D, Thornhill TS (2005) Uncemented glenoid component in total shoulder arthroplasty. Survivorship and outcomes. J Bone Jt Surg Am 87:1284–1292

    Google Scholar 

  20. Matsen FA III, Clinton J, Lynch J, Bertelsen A, Richardson ML (2008) Glenoid component failure in total shoulder arthroplasty. J Bone Jt Surg Am 90:885–896

    Article  Google Scholar 

  21. Merrill A, Guzman K, Miller SL (2009) Gender differences in glenoid anatomy. An anatomic study. Surg Radiol Anat SRA 31(3):S. 183-189. https://doi.org/10.1007/s00276-008-0425-3

    Article  Google Scholar 

  22. Müller AM, Born M, Jung C, Flury M, Kolling C, Schwyzer H-K, Audigé L (2018) Glenosphere size in reverse shoulder arthroplasty: is larger better for external rotation and abduction strength? J Shoulder Elbow Surg 27(1):44–52. https://doi.org/10.1016/j.jse.2017.06.002

    Article  PubMed  Google Scholar 

  23. Nashikkar PS, Scholes CJ, Haber MD (2019) Role of intraoperative navigation in the fixation of the glenoid component in reverse total shoulder arthroplasty: a clinical case-control study. J Bone Jt Surg Am 28(9):1685–1691. https://doi.org/10.1016/j.jse.2019.03.013

    Article  Google Scholar 

  24. Neyton L, Boileau P, Nové-Josserand L, Edwards TB, Walch G (2007) Glenoid bone grafting with a reverse design prosthesis. J Shoulder Elbow Surg 16(3 Suppl):S71–S78. https://doi.org/10.1016/j.jse.2006.02.002

    Article  PubMed  Google Scholar 

  25. Schwartz DG, Kang SH, Lynch TS, Edwards S, Nuber G, Zhang L-Q, Saltzman M (2013) The anterior deltoid’s importance in reverse shoulder arthroplasty: a cadaveric biomechanical study. J Shoulder Elbow Surg 22(3):S. 357-364. https://doi.org/10.1016/j.jse.2012.02.002

    Article  Google Scholar 

  26. Seidl AJ, Williams GR, Boileau P (2016) Challenges in reverse shoulder arthroplasty: addressing glenoid bone loss. Orthopedics. https://doi.org/10.3928/01477447-20160111-01

    Article  PubMed  Google Scholar 

  27. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Jt Surg Br 86(3):S. 388-395. https://doi.org/10.1302/0301-620x.86b3.14024

    Article  Google Scholar 

  28. Verborgt O, De Smedt T, Vanhees M, Clockaerts S, Parizel PM, Van Glabbeek F (2011) Accuracy of placement of the glenoid component in reversed shoulder arthroplasty with and without navigation. J Shoulder Elbow Surg 20:21–26

    Article  Google Scholar 

  29. Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 14(6):756–760. https://doi.org/10.1016/s0883-5403(99)90232-2

    Article  CAS  PubMed  Google Scholar 

  30. Werner BS, Böhm D, Abdelkawi A, Gohlke F (2014) Glenoid bone grafting in reverse shoulder arthroplasty for long-standing anterior shoulder dislocation. J Shoulder Elbow Surg. https://doi.org/10.1016/j.jse.2014.02.017

    Article  PubMed  Google Scholar 

  31. Zumstein MA, Pinedo M, Old J, Boileau P (2011) Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty. A systematic review. J Shoulder Elbow Surg 20(1):S. 146-157. https://doi.org/10.1016/j.jse.2010.08.001

    Article  Google Scholar 

Download references

Funding

No grant or grant support.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nadine Ott.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by our ethical committee, University of Bonn (AZ 125/13).

Informed consent

Informed consent was obtained.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ott, N., Kieback, JD., Welle, K. et al. The base of coracoid process as a reference for glenoid reconstruction in primary or revision reverse shoulder arthroplasty: CT-based anatomical study. Arch Orthop Trauma Surg 142, 387–393 (2022). https://doi.org/10.1007/s00402-020-03642-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-020-03642-w

Keywords

Navigation