Optimal baseplate rotational alignment for locking-screw fixation in reverse total shoulder arthroplasty: a three-dimensional computer-aided design study

Stephens, Byron F.; Hebert, Casey T.; Azar, Frederick M.; Mihalko, William M.; Throckmorton, Thomas W.

doi:10.1016/j.jse.2015.01.012

Cited by 26 publications

(21 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has been ascribed to limited bone stock of the available glenoid, the lack of reliable landmarks to determine the position of the blade of the scapula intra-operatively, and the poor understanding of the anatomical position, which shows great patient-specific variability. Surgeons may tend to aim for a ‘standard’ position of so-called neutral orientation of the glenoid component [6, 7]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

Mathews

Burkhard

Serrano

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundPlacement of the glenoid baseplate is of paramount importance for the outcome of anatomical and reverse total shoulder arthroplasty. However, the database around glenoid size is poor, particularly regarding small scapulae, for example, in women and smaller individuals, and is derived from different methodological approaches. In this multimodality cadaver study, we systematically examined the glenoid using morphological and 3D-CT measurements.MethodsMeasurements of the glenoid and drill hole tunnel length for superior baseplate screw placement were recorded to define size of the glenoid and the distance to the scapular notch on cadaveric specimens. Glenoid angles were determined on both, 3D-CT-scans of the thoraxes using the Friedman method and on subsequently isolated scapulae from 18 male and female donors (average 84 years, range 60–98 years).ResultsMean glenoid height was 36.6 mm ± 3.6, and width 27.8 mm ± 3.1 with a significant sex dimorphism (p ≤ 0.001): in males, glenoid height 39.5 mm ± 3.5, and width 30.3 mm ± 3.3, and in females, glenoid height 34.8 mm ± 2.2, and width 26.2 mm ± 1.6. The average distance from the superior screw entry to its exit in the scapular notch measured by calliper was 27.2 mm ± 6.0 with a sex difference: in males, 29.4 mm ± 5.7, and in females, 25.8 mm ± 5.9 mm with a minimum recorded distance of 15 mm. Measured by CT, the mean inclination angle for male and female donors combined was 13.0° ± 7.0, and the ante-/retroversion angle −1.0° ± 4.0°.ConclusionThis study is one of the first to combine dissection, including drill holes, with anatomical measurements and radiological data. In some women and smaller individuals, smaller baseplates should be selected. The published safe zone of 20 mm is generally feasible for superior screw placement, however, in small patients this distance may be substantially shorter than expected and start as of 13 and 15 mm, respectively. No correlation between glenoid height or width with the length of our drilling canal towards the scapular notch was found. Preoperative CT-based treatment planning to determine version and inclination angles is recommended.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Even less data are available with regard to safe screw placement for (reverse) total shoulder arthroplasty [7], and only a few and methodologically divergent studies have used human cadavers to address the issue of safe screw placement for total or reverse shoulder arthroplasty so far [16, 17, 19, 39, 41, 42]. …”

Section: Introductionmentioning

confidence: 99%

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

Mathews

Burkhard

Serrano

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…The Sirveaux's classification system for scapular notching uses the position of the inferior screw as the guideline for classification, but the ideal screw location during a surgery differs from one patient to another. 21,22) Therefore, the location of the screw is an inherently inconsistent marker of the size and grade of scapular notching. A scapular notching classification that can overcome this drawback is based on the distance between the glenoid component peg or the central screw and the inferior margin of the scapular neck and on the invasion height and ratio of the scapular notching.…”

Section: )mentioning

confidence: 99%

Evaluating Scapular Notching after Reverse Total Shoulder Arthroplasty

Kim¹,

Won²,

Park³

et al. 2015

Clinics in Shoulder and Elbow

View full text Add to dashboard Cite

Background: Scapular notching can happen at diverse location depending on implant design or operative technique, therefore, it is easily misdiagnosed. Thus, this study purposed to suggest a method helpful to assess scapular notching. Methods: The subjects were 73 cases of reverse shoulder arthroplasty (RSA) for cuff tear arthropathy during the period from May 2009 to April 2014 and followed-up for over a year. There was medialized RSA in 22 cases, bone increased offset RSA (BIO-RSA) in 36 cases, and metal increased offset RSA (metal-RSA) in 15 cases. Scapular notching was not determined by bone defect at the inferior of glenosphere as Sirveaux's classification, but scapular notching at the site where the rotational route of the polyethylene of humeral implant met the scapular neck were examined. The results were compared with conventional method. Results: By conventional method, scapular notching was observed in 10 cases (45.5%) in medialized RSA, 12 cases (33.3%) in BIO-RSA, and none in metal-RSA. By new method, it was observed in 9 cases (40.9%) in medialized RSA, 10 cases (27.8%) in BIO-RSA, and none of metal-RSA. The site of scapular notching was apart from glenoshpere in 18 cases, and at inferior of glenosphere in 1 case. Absorption of bone graft was observed in 4 (11.1%) out of 36 cases of BIO-RSA. Conclusions: It is hard to distinguish scapular notching from absorption of bone graft in BIO-RSA, and bone absorption at the lateral lower end of glenoid in medialized RSA. Thus, it is considered useful to assess scapular notching at the site where the rotational route of the polyethylene insert meets scapular neck. (Clin Shoulder Elbow 2015;18(4):248-253)

show abstract

“…As the number of reverse total shoulder arthroplasty and total shoulder arthroplasty performed has been increasing, the glenoid is becoming increasingly more important and many methods for accurate fixation have been presented. [1][2][3][4][5] Kelly et al 6) proposed the '12 mm rule', stating that when inserting the glenoid component, screw placement in the location 12 mm above the inferior glenoid rim led to good results. Theopold et al 7) reported that the accuracy of glenoid component insertion can be improved by navigation based on three-dimensional (3D) images after insertion of the guide wire into the glenoid in the operation.…”

Section: Introductionmentioning

confidence: 99%

Another Glenoid Measurements for Shoulder Surgery

Jeong¹,

Yum²,

Lee³

2018

Clin Shoulder Elbow

View full text Add to dashboard Cite

BACKGROUND: We analyzed the angle between the glenoid anterior surface and glenoid axis, the range of the glenoid apex and the location of the glenoid apex for assistance during shoulder surgery.METHODS: Sixty-two patients underwent a computed tomography of the shoulder with a proximal humerus fracture. In the range of the glenoid apex, the ratios of the distribution of triangles with a Constant anterior and posterior area of the glenoid were measured. The location of glenoid apex was confirmed as the percentage of the position with respect to the upper part of the glenoid with the center of the part, analyzed the angle between the glenoid anterior surface and glenoid axis was measured.RESULTS: The angle between the glenoid anterior surface and glenoid axis was 19.80° ± 3.88°. The location of the glenoid apex is 60.36% ± 9.31%, with the upper end of the glenoid as the reference. The range of the glenoid apex was 21.16% ± 4.98%. When the height of the glenoid becomes smaller, the range of the glenoid apex tends to become larger (p=0.001) and the range of the glenoid apex becomes wider (p=0.001) as the glenoid width narrows.CONCLUSIONS: We believe the anatomical measurements of the glenoid will be helpful for a more accurate insertion in glenoid component. It is thought that more accurate insertion is possible if we can set other anatomical measurements using computed tomography imaging of the glenoid which can develop into the study of other anatomical measurements.

show abstract

Optimal baseplate rotational alignment for locking-screw fixation in reverse total shoulder arthroplasty: a three-dimensional computer-aided design study

Cited by 26 publications

References 19 publications

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

Evaluating Scapular Notching after Reverse Total Shoulder Arthroplasty

Another Glenoid Measurements for Shoulder Surgery

Contact Info

Product

Resources

About