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Compared to SHA, functional outcome was superior with FAPF. However, this was associated with a higher rate of revision surgery. Most patients were still able to live independently in their original environment, regardless of the type of surgery.

Background For optimal prosthetic anchoring in omarthritis surgery, a differentiated knowledge on the mineralisation distribution of the glenoid is important. However, database on the mineralisation of diseased joints and potential relations with glenoid angles is limited. Methods Shoulder specimens from ten female and nine male body donors with an average age of 81.5 years were investigated. Using 3D-CT-multiplanar reconstruction, glenoid inclination and retroversion angles were measured, and osteoarthritis signs graded. Computed Tomography-Osteoabsorptiometry (CT-OAM) is an established method to determine the subchondral bone plate mineralisation, which has been demonstrated to serve as marker for the long-term loading history of joints. Based on mineralisation distribution mappings of healthy shoulder specimens, physiological and different CT-OAM patterns were compared with glenoid angles. Results Osteoarthritis grades were 0-I in 52.6% of the 3D-CT-scans, grades II-III in 34.3%, and grade IV in 13.2%, with in females twice as frequently (45%) higher grades (III, IV) than in males (22%, III). The average inclination angle was 8.4°. In glenoids with inclination ≤10°, mineralisation was predominantly centrally distributed and tended to shift more cranially when the inclination raised to > 10°. The average retroversion angle was − 5.2°. A dorsally enhanced mineralisation distribution was found in glenoids with versions from − 15.9° to + 1.7°. A predominantly centrally distributed mineralisation was accompanied by a narrower range of retroversion angles between − 10° to − 0.4°. Conclusions This study is one of the first to combine CT-based analyses of glenoid angles and mineralisation distribution in an elderly population. The data set is limited to 19 individuals, however, indicates that superior inclination between 0° and 10°-15°, and dorsal version ranging between − 9° to − 3° may be predominantly associated with anterior and central mineralisation patterns previously classified as physiological for the shoulder joint. The current basic research findings may serve as basic data set for future studies addressing the glenoid geometry for treatment planning in omarthritis.

A combination of coracoid fracture and acromioclavicular dislocation is rare. Detecting further pathologies that could cause multiple superior shoulder suspensory complex disruptions is mandatory. Literature regarding these injuries and their management is lacking. We report our diagnostic and surgical strategies, and the postoperative outcomes of superior shoulder suspensory complex disruptions. We present five cases, treated from 2011 to 2016, who had >2 disruptions of the superior shoulder suspensory complex, involving at least a coracoid fracture and an acromioclavicular joint dislocation. Surgical reconstruction was performed in all cases. The patients were postoperatively followed up for a year. There were no intraoperative or postoperative complications, and bone union was achieved in all fractures. Furthermore, all patients returned to their pre-surgery activity level and jobs. Thus, we could demonstrate that in multiple superior shoulder suspensory complex disruptions involving a coracoid fracture and an acromioclavicular joint dislocation, surgical treatment leads to a good functional outcome.

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