Progression of Glenoid Morphology in Glenohumeral Osteoarthritis

Walker, Kyle E.; Simcock, Xavier; Jun, Bong Jae; Iannotti, Joseph P.; Ricchetti, Eric T.

doi:10.2106/jbjs.17.00064

Cited by 75 publications

(63 citation statements)

References 20 publications

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“…Posterior humeral subluxation and glenoid retroversion was as well were related to posterior cuff ratio [21]. Moreover Aleem et al [21] did not find a correlation of glenoid inclination with rotator cuff muscle area whereas, Walker et al [24] and Donohue et al [23] described the association of increased posterior muscle fatty infiltration with posterior glenoid bone loss and glenoid retroversion, which is in line with our findings. Our data showed that posterior and posterosuperior glenoid wear was seen in 98% of patients with rotator cuff tears compared to only 91,5% in rotator cuff intact patients.…”

Section: Discussionsupporting

confidence: 90%

“…The effects of glenoid version and inclination on rotator cuff integrity are not clearly established. Some recent studies focused on the relationship between rotator cuff integrity, fatty infiltration and glenoid deformity [21][22][23][24]. Increased glenoid retroversion was associated with a high crosssectional area of the supraspinatus and infraspinatus, rather than the low cross-sectional area of subscapularis [22].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, in our "intact cuff" group also posterior-superior glenoid wear, but mostly to a minor extend was seen in 35.8% of the patients. In literature this was attributed to rotator cuff muscle atrophy or fatty infiltration [23,24].…”

Section: Discussionmentioning

confidence: 99%

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The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty

Özel

Hudek

Abdrabou

et al. 2020

BMC Musculoskelet Disord

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Background The success of shoulder arthroplasty, both reverse and anatomical, depends on correcting the underlying glenoid deformity especially in patients with an osteoarthritis. We hypothesized that the distribution of glenoid version and especially inclination are underestimated in the shoulder arthritis population, and also that superior glenoid inclination can be detected through 3-dimensional (3D) software program of computed tomography (CT) to a greater proportion in patients with rotator cuff insufficiency, but also in patients with osteoarthritis with an intact rotator cuff. Because of the influence of rotator cuff imbalance on secondary glenoid wear the values of the critical shoulder angle (CSA) and the fatty infiltration of the rotator cuff are further analyzed. The aim of our study is to determine; 1) the distribution of glenoid inclination and version; 2) the relationship between glenoid inclination, version, the critical shoulder angle (CSA) to the status of the rotator cuff; 3) the proportion of patients with both an intact rotator cuff and a superior inclination greater than 10°. Methods A total of 231 shoulders were evaluated with X-ray images, 3-dimentional (3D) software program of computed tomography (CT), and magnetic resonance imaging. The cohort was divided into 3 groups according to their inclination angles and also grouped as intact-rotator cuff and torn-cuff group. Results The median (min/max) values for the 231 shoulders were 8° (− 23°/56°) for the inclination angle, − 11°(− 55°/23°) for the version angle, and 31.5°(17.6°/61.6°) for the CSA. The majority of the glenoids were found to show posterior-superior erosion. Glenoid inclination angle and CSA were significantly higher in torn-cuff group when compared with intact-cuff group (P < 0.001, both). The rotator cuff tears were statistically significant in high inclination group than low inclination group and no inclination group (p < 0.001). In the high inclination group, 41 of 105 (39%) shoulders had an intact rotator cuff, in about 18% of all shoulders. Conclusion Our findings show that 3D evaluation of glenoid inclination is mandatory for preoperative planning of shoulder replacement in order to properly assess superior inclination and that reverse shoulder arthroplasty may be considered more frequently than as previously expected, even when the rotator cuff is intact. Level of evidence Level III.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty

Özel

Hudek

Abdrabou

et al. 2020

BMC Musculoskelet Disord

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“…Prior investigations with regard to rotator cuff muscle health in arthritic shoulders demonstrated some differences from our study. Walker et al attempted to determine temporal relationships in glenohumeral osteoarthritis 23 . In a series of 65 shoulders with CT scans at least 2 years apart and with known osteoarthritis, patients with initial posterior subluxation were more likely to progress to worsening deformity and to demonstrate a higher percentage of fatty infiltration in the rotator cuff compared with shoulders without subluxation.…”

Section: Discussionmentioning

confidence: 99%

Association Between Rotator Cuff Muscle Size and Glenoid Deformity in Primary Glenohumeral Osteoarthritis

Aleem

Chalmers

Bechtold

et al. 2019

The Journal of Bone and Joint Surgery

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Background: Although glenoid morphology has been associated with fatty infiltration of the rotator cuff in arthritic shoulders, the association of rotator cuff muscle area with specific patterns of glenoid wear has not been studied. The purpose of our study was to assess the associations of glenoid deformity in primary glenohumeral osteoarthritis and rotator cuff muscle area. Methods: A retrospective study of 370 computed tomographic (CT) scans of osteoarthritic shoulders was performed. Glenoid deformity according to the modified Walch classification was determined, and retroversion, inclination, and humeral-head subluxation were calculated using automated 3-dimensional software. Rotator cuff muscle area was measured on sagittal CT scan reconstructions. A ratio of the area of the posterior rotator cuff muscles to the subscapularis was calculated to approximate axial plane potential force imbalance. Univariate and multivariate analyses to determine associations with glenoid bone deformity and rotator cuff measurements were performed. Results: Patient age and sex were significantly related to cuff muscle area across glenoid types. Multivariate analysis did not find significant differences in individual rotator cuff cross-sectional areas across glenoid types, with the exception of a larger supraspinatus area in Type-B2 glenoids compared with Type-A glenoids (odds ratio [OR], 1.5; p = 0.04). An increased ratio of the posterior cuff area to the subscapularis area was associated with increased odds of a Type-B2 deformity (OR, 1.3; p = 0.002). Similarly, an increase in this ratio was significantly associated with increased glenoid retroversion (beta = 0.92; p = 0.01) and humeral-head subluxation (beta = 1.48; p = 0.001). Within the Type-B glenoids, only posterior humeral subluxation was related to the ratio of the posterior cuff to the subscapularis (beta = 1.15; p = 0.001). Conclusions: Age and sex are significantly associated with cuff muscle area in arthritic shoulders. Asymmetric glenoid wear and humeral-head subluxation in osteoarthritis are associated with asymmetric atrophy within the rotator cuff transverse plane. Increased posterior rotator cuff muscle area compared with anterior rotator cuff muscle area is associated with greater posterior glenoid wear and subluxation. It is unclear if the results are causative or associative; further research is required to clarify the relationship.

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“…For those glenoids that showed medialization, B-type glenoids showed more medialization over time than A-type glenoids. 38 In a follow-up study, Donohue et al analyzed 190 CT scans in 175 patients who underwent TSA for glenohumeral OA to assess the relationship of glenoid morphology and rotator cuff pathology. Using 3D CT and respective 2D images, pathologic glenoid version and joint line, modified Walch classification and Goutallier classification were determined.…”

Section: D Ct Characteristics Of the B2 Glenoidmentioning

confidence: 99%

Imaging of the B2 Glenoid: An Assessment of Glenoid Wear

Mahylis

Entezari

Jun

et al. 2019

Journal of Shoulder and Elbow Arthroplasty

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Background: Glenohumeral osteoarthritis (OA) carries a spectrum of morphology and wear patterns of the glenoid surface exemplified by complex patterns such as glenoid biconcavity and acquired retroversion seen in the B2 glenoid. Multiple imaging methods are available for evaluation of the complex glenoid structure seen in B2 glenoids. The purpose of this article is to review imaging assessment of the type B2 glenoid. Methods: The current literature on imaging of the B2 glenoid was reviewed to describe the unique anatomy of this OA variant and how to appropriately assess its characteristics. Results: Plain radiographs, magnetic resonance imaging, and standard 2-dimensional computed tomography (CT) have all shown acceptable assessments of arthritic glenoids but lack the detailed and highly accurate evaluation of bone loss and retroversion seen with 3-dimensional CT. Conclusion: Accurate preoperative identification of complex B2 pathology on imaging remains essential in planning and achieving precise implant placement at the time of shoulder arthroplasty.

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Progression of Glenoid Morphology in Glenohumeral Osteoarthritis

Abstract: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 75 publications

References 20 publications

The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty

The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty

Association Between Rotator Cuff Muscle Size and Glenoid Deformity in Primary Glenohumeral Osteoarthritis

Imaging of the B2 Glenoid: An Assessment of Glenoid Wear

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