Skip to main content
SpringerLink
Log in

Biometrical analysis of the shoulder joint regarding glenoid implant dimensions for arthroplasty

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

Reduced bone stock and difficult intraoperative orientation are challenges in glenoid replacement surgery. New implant designs and methods for fixation, such as locking screws, extra-long central pegs and/or central compression screws are targeting these issues. The objective of this study is the analysis of the glenoid dimension regarding maximum central peg diameter and peg length (PL), and maximum screw length (SL) for glenoid fixation.

Methods

Retrospective analysis of magnetic resonance imaging (n = 50) scans. Measurement of the maximum inferior glenoid diameter (GD), SL, maximum length of a 9.9, 10 and 11.4 mm central peg (PL) in the transverse plane; glenoid version (GV), humeral head diameter (HHD). Two independent measurements.

Results

Mean age: 49.0 ± 15.7 years (17–80) (n = 20 female, 49.6 ± 16.0; n = 30 male, 48.6 ± 15.7). Mean values of measurement were GD: 28.9 ± 3.7 mm (21–39); SL: 34.1 ± 4.9 mm (26–44); PL 9.9 mm: 19.4 ± 4.3 mm (9–30); PL 10 mm: 19.0 ± 4.4 mm (8–30); PL 11.4 mm: 16.5 ± 4.1 mm (7–26) with significant gender differences (p = 0.001; p = 0.022; p = 0.001); GV: −0.6° ± 4.9° (−10 to 11); HHD: 50.0 mm ± 4.9 (41–61). There was good correlation between PL and SL (r = 0.32, p = 0.024) and for GD and PL (r = 0.61, p = 0.001; r = 0.57, p = 0.001; r = 0.96, p = 0.001). The ratio of HHD and GD was very constant with 0.6 ± 0.07.

Conclusions

These data indicate the high interindividual variability of glenoid morphology including significant gender-related differences. The good correlation between humeral head size and GD and maximum central PL can be helpful for cases with reduced bone stock in decision-making about implant size and bone grafting.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Anglin C, Tolhurst P, Wyss UP, Pichora DR (1999) Glenoid cancellous bone strength and modulus. J Biomech 32(10):1091–1097

    Article  CAS  PubMed  Google Scholar 

  2. Bicknell RT, Patterson SD, King GJ, Chess DG, Johnson JA (2007) Glenoid vault endosteal dimensions: an anthropometric study with special interest in implant design. J Should Elb Surg 16(3 Suppl):S96–S101. doi:10.1016/j.jse.2006.03.008

    Article  Google Scholar 

  3. Boileau P, Walch G (1999) Normal and pathological anatomy of the glenoid: effects on the design, preparation and fixation of the glenoid component. In: Walch G, Boileau P (eds) Shoulder arthroplasty, vol 1. Springer, Berlin, pp 127–140

    Chapter  Google Scholar 

  4. Checroun AJ, Hawkins C, Kummer FJ, Zuckerman JD (2002) Fit of current glenoid component designs: an anatomic cadaver study. J Should Elb Surg 11(6):614–617. doi:10.1067/mse.2002.126099

    Article  Google Scholar 

  5. Churchill RS, Brems JJ, Kotschi H (2001) Glenoid size, inclination, and version: an anatomic study. J Should Elb Surg 10(4):327–332. doi:10.1067/mse.2001.115269

    Article  CAS  Google Scholar 

  6. Cil A, Veillette CJ, Sanchez-Sotelo J, Sperling JW, Schleck CD, Cofield RH (2010) Survivorship of the humeral component in shoulder arthroplasty. J Should Elb Surg 19(1):143–150. doi:10.1016/j.jse.2009.04.011

    Article  Google Scholar 

  7. Couteau B, Mansat P, Mansat M, Darmana R, Egan J (2001) In vivo characterization of glenoid with use of computed tomography. J Should Elb Surg 10(2):116–122. doi:10.1067/mse.2001.112884

    Article  CAS  Google Scholar 

  8. Cyprien JM, Vasey HM, Burdet A, Bonvin JC, Kritsikis N, Vuagnat P (1983) Humeral retrotorsion and glenohumeral relationship in the normal shoulder and in recurrent anterior dislocation (scapulometry). Clin Orthop Relat Res 175:8–17

    PubMed  Google Scholar 

  9. De Wilde L, Defoort S, Verstraeten TR, Speeckaert W, Debeer P (2012) A 3D-CT scan study of the humeral and glenoid planes in 150 normal shoulders. Surg Radiol Anat 34(8):743–750. doi:10.1007/s00276-011-0836-4

    Article  PubMed  Google Scholar 

  10. Deutsch A, Abboud JA, Kelly J, Mody M, Norris T, Ramsey ML, Iannotti JP, Williams GR (2007) Clinical results of revision shoulder arthroplasty for glenoid component loosening. J Should Elb Surg 16(6):706–716. doi:10.1016/j.jse.2007.01.007

    Article  Google Scholar 

  11. Edelson JG (1995) Localized glenoid hypoplasia. An anatomic variation of possible clinical significance. Clin Orthop Relat Res 321:189–195

    PubMed  Google Scholar 

  12. Friedman RJ, Hawthorne KB, Genez BM (1992) The use of computerized tomography in the measurement of glenoid version. J Bone Jt Surg (A) 74(7):1032–1037

    CAS  Google Scholar 

  13. Habermeyer P, Kircher J (2010) Standardendoprothetik. In: Habermeyer P, Lichtenberg S, Magosch P (eds) Schulterchirurgie, 4th edn. Elsevier/Urban & Fischer, München, pp 655–745

    Google Scholar 

  14. Iannotti JP, Gabriel JP, Schneck SL, Evans BG, Misra S (1992) The normal glenohumeral relationships. An anatomical study of one hundred and forty shoulders. J Bone Jt Surg (A) 74(4):491–500

    CAS  Google Scholar 

  15. Inui H, Sugamoto K, Miyamoto T, Machida A, Hashimoto J, Nobuhara K (2001) Evaluation of three-dimensional glenoid structure using MRI. J Anat 199(Pt 3):323–328

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Jeske HC, Oberthaler M, Klingensmith M, Dallapozza C, Smekal V, Wambacher M, Kralinger F (2009) Normal glenoid rim anatomy and the reliability of shoulder instability measurements based on intrasite correlation. Surg Radiol Anat 31(8):623–625. doi:10.1007/s00276-009-0492-0

    Article  PubMed  Google Scholar 

  17. Kircher J, Morhard M, Gavriilidis I, Magosch P, Lichtenberg S, Habermeyer P (2010) Is there an association between a low acromion index and osteoarthritis of the shoulder? Int Orthop 34–7:1005–1010

    Article  Google Scholar 

  18. Kircher J, Morhard M, Magosch P, Ebinger N, Lichtenberg S, Habermeyer P (2010) How much are radiological parameters related to clinical symptoms and function in osteoarthritis of the shoulder? Int Orthop 34(5):677–681. doi:10.1007/s00264-009-0846-6

    Article  PubMed Central  PubMed  Google Scholar 

  19. Kraljevic M, Zumstein V, Hugli R, Muller-Gerbl M (2013) A comparison of subchondral bone mineralization between the glenoid cavity and the humeral head on 57 cadaverous shoulder joints. Surg Radiol Anat 35(4):295–300. doi:10.1007/s00276-012-1034-8

    Article  PubMed  Google Scholar 

  20. Mallon WJ, Brown HR, Vogler JB 3rd, Martinez S (1992) Radiographic and geometric anatomy of the scapula. Clin Orthop Relat Res 277:142–154

    PubMed  Google Scholar 

  21. Melis B, Bonnevialle N, Neyton L, Levigne C, Favard L, Walch G, Boileau P (2012) Glenoid loosening and failure in anatomical total shoulder arthroplasty: is revision with a reverse shoulder arthroplasty a reliable option? J Should Elb Surg 21(3):342–349. doi:10.1016/j.jse.2011.05.021

    Article  Google Scholar 

  22. Merrill A, Guzman K, Miller SL (2009) Gender differences in glenoid anatomy: an anatomic study. Surg Radiol Anat 31(3):183–189. doi:10.1007/s00276-008-0425-3

    Article  PubMed  Google Scholar 

  23. Miyazaki AN, Itoi E, Sano H, Fregoneze M, Santos PD, da Silva LA, Sella Gdo V, Martel EM, Debom LG, Andrade ML, Checchia SL (2011) Comparison between the acromion index and rotator cuff tears in the Brazilian and Japanese populations. J Should Elb Surg 20(7):1082–1086. doi:10.1016/j.jse.2011.04.028

    Article  Google Scholar 

  24. Mullaji AB, Beddow FH, Lamb GH (1994) CT measurement of glenoid erosion in arthritis. J Bone Jt Surg Br 76(3):384–388

    CAS  Google Scholar 

  25. Namdari S, Goel DP, Romanowski J, Glaser D, Warner JJ (2011) Principles of glenoid component design and strategies for managing glenoid bone loss in revision shoulder arthroplasty in the absence of infection and rotator cuff tear. J Should Elb Surg 20(6):1016–1024. doi:10.1016/j.jse.2011.03.016

    Article  Google Scholar 

  26. Putz R, Müller-Gerbl M (2010) Topografie und funktionelle Anatomie des Schultergürtels und des Schultergelenkes. In: Habermeyer P, Lichtenberg S, Magosch P (eds) Schulterchirurgie, 4th edn. Elsevier/Urban & Fischer, München, pp 2–20

    Google Scholar 

  27. Randelli M, Gambrioli PL (1986) Glenohumeral osteometry by computed tomography in normal and unstable shoulders. Clin Orthop Relat Res 208:151–156

    PubMed  Google Scholar 

  28. Scalise JJ, Codsi MJ, Bryan J, Iannotti JP (2008) The three-dimensional glenoid vault model can estimate normal glenoid version in osteoarthritis. J Should Elb Surg 17(3):487–491. doi:10.1016/j.jse.2007.09.006

    Article  Google Scholar 

  29. van de Sande MA, Brand R, Rozing PM (2006) Indications, complications, and results of shoulder arthroplasty. Scand J Rheumatol 35(6):426–434

    Article  PubMed  Google Scholar 

  30. von Schroeder HP, Kuiper SD, Botte MJ (2001) Osseous anatomy of the scapula. Clin Orthop Relat Res 383:131–139

    Article  Google Scholar 

  31. Wirth MA, Lyons FR, Rockwood CA Jr (1993) Hypoplasia of the glenoid. A review of sixteen patients. J Bone Jt Surg (A) 75(8):1175–1184

    CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopedics, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstrasse 5, 40255, Düsseldorf, Germany

    Jörn Kircher, Bernd Bittersohl, Christoph Zilkens & Rüdiger Krauspe

  2. Department of Shoulder and Elbow Surgery, Klinik Fleetinsel Hamburg, Admiralitätstr. 3-4, 20459, Hamburg, Germany

    Jörn Kircher & Achim Hedtmann

Authors
  1. Jörn Kircher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bernd Bittersohl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christoph Zilkens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Achim Hedtmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rüdiger Krauspe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jörn Kircher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kircher, J., Bittersohl, B., Zilkens, C. et al. Biometrical analysis of the shoulder joint regarding glenoid implant dimensions for arthroplasty. Surg Radiol Anat 36, 321–325 (2014). https://doi.org/10.1007/s00276-013-1197-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-013-1197-y

Keywords

Search

Navigation