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.
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References
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
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
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
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
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
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
Gavaskar AS, Vijayraj K, Subramanian SM (2013) Intraoperative CT navigation for glenoid component fixation in reverse shoulder arthroplasty. Indian J Orthop 47:104–106
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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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
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DOI: https://doi.org/10.1007/s00402-020-03642-w