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Standard radiological classification of glenohumeral osteoarthritis does not correlate with the complexity of the arthritic glenoid deformity

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

Abstract

Background

The Samilson-Prieto classification (SPC) depending on the humeral osteophyte length on a-pX-rays today is widely used to classify glenohumeral osteoarthritis in general. For treatment planning and prognosis, the patho-morphology of the glenoid and static posterior subluxation of the humeral head classified according to Walch is of much higher importance. Here, usually a CT or MRI scan is required for a correct classification. A possible correlation between both classifications is poorly explored. Without it, the complexity of the case might be mis-interpreted using the SPC. The aim of this study was to investigate such a correlation, i.e. whether it correlates with the glenoid deformity and degree of humeral head subluxation.

Patients and methods

Radiological datasets (X-ray and CT or MRI) of 352 patients with primary OA of the shoulder were evaluated by two observers experienced in shoulder surgery. For the Samilson-Prieto classification, true a-p shoulder radiographs and for the modified Walch classification CT or MRI scans in the axial plane were interpreted using a validated method. To investigate a correlation between both classifications, the Fisher’s exact test was used. For the interobserver reliability, the weighted kappa coefficient κ was determined.

Results

For the Walch classification, both observers found a similar percentage for the different types, with decreasing numbers from normal (type A1) to severely altered glenoids In the Samilson-Prieto classification, OA grade I was predominant, while grade II and III showed a relatively equal distribution. Interobserver reliability was high both for the Walch classification with a κ 0.923 (95% confidence interval 0.892; 0.954) and) for the SPC with a κ 0.88 (95% confidence interval 0.843; 0.916). A correlation between the two classifications in Fischer’s exact test could not be shown (p = 0.584).

Discussion

Since there is no correlation between both, using the Samilson-Prieto classification alone might miss relevant prognostic factors in gleno-humeral OA. Adequate imaging of the glenoid morphology also in the axial plane is absolutely mandatory to understand the complexity and chose the right treatment for each patient.

Level of evidence

Study of Diagnostic Test—Level II.

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References

  1. Pandya J, Johnson T, Low AK (2018) Shoulder replacement for osteoarthritis: a review of surgical management. Maturitas 108:71–76

    Article  Google Scholar 

  2. Oppermann J, Celik E, Bredow J et al (2016) Shoulder arthroplasty in Germany: 2005–2012. Arch Orthop Trauma Surg 136:723–729

    Article  Google Scholar 

  3. Seifarth A, Roemer F (2015) Systematics of glenohumoral and acromioclavicular arthritis. Radiologe 55:231–240

    Article  CAS  Google Scholar 

  4. Samilson RL, Prieto V (1983) Dislocation arthropathy of the shoulder. J Bone Joint Surg Am 65:456–460

    Article  CAS  Google Scholar 

  5. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502

    Article  CAS  Google Scholar 

  6. Brox JI, Lereim P, Merckoll E et al (2003) Radiographic classification of glenohumeral arthrosis. Acta Orthop Scand 74:186–189

    Article  Google Scholar 

  7. Juel NG, Brox JI, Hellund JC et al (2018) Radiological glenohumeral osteoarthritis in long-term type 1 diabetes. Prevalence and reliability of three classification systems. The dialong shoulder study. Skeletal Radiol 47:1245–1251

    Article  Google Scholar 

  8. Elsharkawi M, Cakir B, Reichel H et al (2013) Reliability of radiologic glenohumeral osteoarthritis classifications. J Shoulder Elbow Surg 22:1063–1067

    Article  Google Scholar 

  9. Bercik MJ, Kruse K 2nd, Yalizis M et al (2016) A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg 25:1601–1606

    Article  Google Scholar 

  10. Walch G, Badet R, Boulahia A et al (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 14:756–760

    Article  CAS  Google Scholar 

  11. Castagna A, Garofalo R (2019) Journey of the glenoid in anatomic total shoulder replacement. Shoulder Elbow 11:140–148

    Article  Google Scholar 

  12. Hill JM, Norris TR (2001) Long-term results of total shoulder arthroplasty following bone-grafting of the glenoid. J Bone Joint Surg Am 83:877–883

    Article  CAS  Google Scholar 

  13. Mizuno N, Denard PJ, Raiss P et al (2013) Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid. J Bone Joint Surg Am 95:1297–1304

    Article  Google Scholar 

  14. Habermeyer P, Magosch P, Luz V et al (2006) Three-dimensional glenoid deformity in patients with osteoarthritis: a radiographic analysis. J Bone Joint Surg Am 88:1301–1307

    CAS  PubMed  Google Scholar 

  15. Friedman RJ, Hawthorne KB, Genez BM (1992) The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 74:1032–1037

    Article  CAS  Google Scholar 

  16. Rouleau DM, Kidder JF, Pons-Villanueva J et al (2010) Glenoid version: How to measure it? Validity of different methods in two-dimensional computed tomography scans. J Shoulder Elbow Surg 19:1230–1237

    Article  Google Scholar 

  17. McHugh ML (2012) Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 22:276–282

    Article  Google Scholar 

  18. Denard PJ, Walch G (2013) Current concepts in the surgical management of primary glenohumeral arthritis with a biconcave glenoid. J Shoulder Elbow Surg 22:1589–1598

    Article  Google Scholar 

  19. Raiss P, Loew M, Bruckner T et al (2019) Risk factors for loosening of cemented glenoid components in anatomical shoulder arthroplasty. Obere Extremität 14:197–201

    Article  Google Scholar 

  20. Walch G, Moraga C, Young A et al (2012) Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid. J Shoulder Elbow Surg 21:1526–1533

    Article  Google Scholar 

  21. Hawi N, Magosch P, Tauber M et al (2017) Glenoid deformity in the coronal plane correlates with humeral head changes in osteoarthritis: a radiographic analysis. J Shoulder Elbow Surg 26:253–257

    Article  Google Scholar 

  22. Kobayashi T, Takagishi K, Shitara H et al (2014) Prevalence of and risk factors for shoulder osteoarthritis in Japanese middle-aged and elderly populations. J Shoulder Elbow Surg 23:613–619

    Article  Google Scholar 

  23. Weinstein DM, Bucchieri JS, Pollock RG et al (2000) Arthroscopic debridement of the shoulder for osteoarthritis. Arthroscopy 16:471–476

    Article  CAS  Google Scholar 

  24. Habermeyer P, Magosch P, Weiss C et al (2017) Classification of humeral head pathomorphology in primary osteoarthritis: a radiographic and in vivo photographic analysis. J Shoulder Elbow Surg 26:2193–2199

    Article  Google Scholar 

  25. Sirveaux F, Favard L, Oudet D et al (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 Joint Surg Br 86:388–395

    Article  CAS  Google Scholar 

  26. Jacxsens M, Van Tongel A, Henninger HB et al (2016) A three-dimensional comparative study on the scapulohumeral relationship in normal and osteoarthritic shoulders. J Shoulder Elbow Surg 25:1607–1615

    Article  Google Scholar 

  27. Jacxsens M, Van Tongel A, Henninger HB et al (2017) The three-dimensional glenohumeral subluxation index in primary osteoarthritis of the shoulder. J Shoulder Elbow Surg 26:878–887

    Article  Google Scholar 

  28. Knowles NK, Carroll MJ, Keener JD et al (2016) A comparison of normal and osteoarthritic humeral head size and morphology. J Shoulder Elbow Surg 25:502–509

    Article  Google Scholar 

  29. Youderian AR, Ricchetti ET, Drews M et al (2014) Determination of humeral head size in anatomic shoulder replacement for glenohumeral osteoarthritis. J Shoulder Elbow Surg 23:955–963

    Article  Google Scholar 

  30. Aronowitz JG, Harmsen WS, Schleck CD et al (2017) Radiographs and computed tomography scans show similar observer agreement when classifying glenoid morphology in glenohumeral arthritis. J Shoulder Elbow Surg 26:1533–1538

    Article  Google Scholar 

  31. Beeler S, Hasler A, Gotschi T et al (2018) Different acromial roof morphology in concentric and eccentric osteoarthritis of the shoulder: a multiplane reconstruction analysis of 105 shoulder computed tomography scans. J Shoulder Elbow Surg 27:e357–e366

    Article  Google Scholar 

  32. Donohue KW, Ricchetti ET, Ho JC et al (2018) The association between rotator cuff muscle fatty infiltration and glenoid morphology in glenohumeral osteoarthritis. J Bone Joint Surg Am 100:381–387

    Article  Google Scholar 

  33. Shukla DR, McLaughlin RJ, Lee J et al (2019) Intraobserver and interobserver reliability of the modified walch classification using radiographs and computed tomography. J Shoulder Elbow Surg 28:625–630

    Article  Google Scholar 

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Author notes

  1. Philip M. Linke, Katrin Zemke contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany

    Philip M. Linke, Niklas Unter Ecker, Joerg Neumann & Andreas W. Werner

  2. Department of Orthopaedic Surgery, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Germany

    Katrin Zemke

  3. MVZ Argon, Department of Sports Medicine/Orthopaedics, Argon Orthopaedie and Helios ENDO Clinic, Große Bleichen 5, 20354, Hamburg, Germany

    Andreas W. Werner

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  1. Philip M. Linke
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Correspondence to Andreas W. Werner.

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Linke, P.M., Zemke, K., Ecker, N.U. et al. Standard radiological classification of glenohumeral osteoarthritis does not correlate with the complexity of the arthritic glenoid deformity. Arch Orthop Trauma Surg 142, 1413–1420 (2022). https://doi.org/10.1007/s00402-021-03758-7

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  • DOI: https://doi.org/10.1007/s00402-021-03758-7

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