Regional bone density variations in osteoarthritic glenoids: a comparison of symmetric to asymmetric (type B2) erosion patterns

Knowles, Nikolas K.; Athwal, George S.; Keener, Jay D.; Ferreira, Louis M.

doi:10.1016/j.jse.2014.07.004

Cited by 40 publications

(49 citation statements)

References 34 publications

(43 reference statements)

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“…Both of these findings support the assertion that component design was the primary determinant of the findings seen. A final limitation for this study is that in vivo remodeling of subchondral glenoid bone density in osteoarthritis was not modeled and also might affect implant fixation [4,26,38]. This limitation is inherent in cadaveric and synthetic test models.…”

Section: Discussionmentioning

confidence: 99%

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Wang

Abrams

Behn

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Uncorrected glenoid retroversion during total shoulder arthroplasty may lead to an increased likelihood of glenoid prosthetic loosening. Augmented glenoid components seek to correct retroversion to address posterior glenoid bone loss, but few biomechanical studies have evaluated their performance. Questions/purposes We compared the use of augmented glenoid components with eccentric reaming with standard glenoid components in a posterior glenoid wear model. The primary outcome for biomechanical stability in this model was assessed by (1) implant edge displacement in superior and inferior edge loading at intervals up to 100,000 cycles, with secondary outcomes including (2) implant edge load during superior and inferior translation at intervals up to 100,000 cycles, and (3) incidence of glenoid fracture during implant preparation and after cyclic loading. Methods A 12°-posterior glenoid defect was created in 12 composite scapulae, and the specimens were divided in two equal groups. In the posterior augment group, glenoid version was corrected to 8°and an 8°-augmented polyethylene glenoid component was placed. In the eccentric reaming group, anterior glenoid reaming was performed to neutral version and a standard polyethylene glenoid component was placed. Specimens were cyclically loaded in the superoinferior direction to 100,000 cycles. Superior and inferior glenoid edge displacements were recorded. Results Surviving specimens in the posterior augment group showed greater displacement than the eccentric reaming group of superior (1.01 ± 0.02 [95% CI, 0.89-1.13] versus 0. 83 ± 0.10 [95% CI,

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Section: Discussionmentioning

confidence: 99%

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Wang

Abrams

Behn

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…A minimum threshold of 200 Hounsfield units (HU) was used to preserve both cancellous and cortical bone in the model geometry. 2,10 Osseous landmarks were used to define the coronal scapular plane and the 0 version plane, as previously described. 6,7,11,14,16 A plane was also created to define the 3D version of the neoglenoid ( Fig.…”

Section: Glenoid Models and Virtual Implantationmentioning

confidence: 99%

“…A mask of this model was then created in Mimics to register the geometry of the bone section to the original DICOM images. Using a minimum threshold of 200 HU to preserve both cancellous and cortical bone, 2,10 bone density and porosity were measured as previously described by Knowles et al 10 The bone density was measured in Hounsfield units with the built-in Mimics measurement tools, and bone porosity was calculated as the ratio of void volume (cysts or low-density cancellous bone below the 200 HU threshold) to total volume. This measurement region represents the bone 0 to 2.5 mm below the implant, on which the implant rests.…”

Section: Density and Porosity Of Bone Beneath The Implantmentioning

confidence: 99%

“…In addition, the distribution of subarticular bone density in B2 glenoids is characteristically different compared with symmetrically eroded glenoids. 10,18 Bone density is greatest in the subarticular bone of the posterior eroded glenoid facet, or neoglenoid as termed by Walch et al 5,21 As such, the neoglenoid contains thicker, denser, and less porous bone. Unfortunately, this good-quality bone in the neoglenoid is found in the subarticular zone only and diminishes with greater depth.…”

mentioning

confidence: 99%

“…Unfortunately, this good-quality bone in the neoglenoid is found in the subarticular zone only and diminishes with greater depth. 10,18 Augmented implant preparation techniques that involve removal of substantial amounts of the neoglenoid bone may leave behind less dense bone with greater porosity to support the implant for its life span.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Augmented glenoid component designs for type B2 erosions: a computational comparison by volume of bone removal and quality of remaining bone

Knowles

Ferreira

Athwal

2015

Journal of Shoulder and Elbow Surgery

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Quantification of regional variations in glenoid trabecular bone architecture and mineralization using clinical computed tomography images

Jun

Vasanji²,

Ricchetti

et al. 2017

Journal Orthopaedic Research

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The purpose of this study was to demonstrate feasibility of a clinical CT imaging and analysis technique to quantify regional variations in trabecular bone architecture and mineralization of glenoid bones. Specifically, our objective was to determine to what extent clinical CT imaging of intact upper extremities can describe variations of trabecular bone architectures at anatomic and peri-implant regions by comparing trabecular bone architectures as measured by high-resolution, micro CT imaging of same excised glenoid bones. Bone volume fraction (BVF), trabecular bone thickness (TbTh), number of trabecular bone (TbN), spacing (TbS), pattern factor (TbPf), bone surface area (BSA), and skeletal connectivity (Conn.), in addition to bone mineral content (BMC) and bone mineral density (BMD), were quantified from both clinical and micro CT images using whole bone, anatomic, and peri-implant bone masks. Strong correlations of BVF, TbTh, TbSp, BMC, and BMD were found between clinical CT and micro CT imaging methods. The variations in BVF, TbTh, TbSp, TbN, BMC, and BMD at anatomical and peri-implant regions were larger than those at whole bone regions. In this study, we have demonstrated that this clinical CT imaging methodology can be used to quantify variations of a patient's glenoid bone at anatomic and peri-implant levels. Statement of Clinical Significance. An in vivo quantitative assessment of glenoid trabecular bone architecture in the anatomic and peri-implant regions may improve our understanding on the role of bone quality on glenoid component loosening following total shoulder arthroplasty. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:85-96, 2018.

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Regional bone density variations in osteoarthritic glenoids: a comparison of symmetric to asymmetric (type B2) erosion patterns

Cited by 40 publications

References 34 publications

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Augmented glenoid component designs for type B2 erosions: a computational comparison by volume of bone removal and quality of remaining bone

Quantification of regional variations in glenoid trabecular bone architecture and mineralization using clinical computed tomography images

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