“…4). If the glenoid orientation is not restored during anatomic shoulder arthroplasty, the shear force to the glenoid component might increase 16 . The present results indicate that glenoid orientation should be assessed with respect to the glenoid longitudinal axis in the operative management of asymmetric posteroinferior bone loss of arthritic glenoids.Figure 4( A ) A 68-year-old woman with primary osteoarthritis.…”
Section: Discussionmentioning
confidence: 83%
“…Bouchaib et al 2 evaluated 2-dimensional glenoid version on the reconstructed axial plane perpendicular to the longitudinal axis of the glenoid surface. During shoulder arthroplasty, it is important to recognize the respective glenoid orientation for proper placement of the glenoid component within the glenoid vault 15, 16 , 28, 34. Unless the preoperatively measured values represent proper glenoid orientation, the glenoid would be reconstructed inadequately.…”
BackgroundThe longitudinal axis of the glenoid is not always parallel to the scapular body, and glenoid torsion could affect the values of glenoid orientation. The purpose of this study was to evaluate 3-dimensional glenoid version and inclination modified by glenoid torsion and to clarify the differences between the values of conventional and of modified glenoid orientations.MethodsComputed tomography scans of 30 shoulders without shoulder pathology, 30 shoulders with primary osteoarthritis, and 30 shoulders with a massive rotator cuff tear or cuff tear arthropathy were retrospectively evaluated. After determining the glenoid axis and the scapular planes and calculating conventional glenoid version and inclination, modified glenoid version and inclination, and glenoid torsion, the values of conventional glenoid orientation and those of modified glenoid orientation were compared statistically.ResultsAll shoulders showed anterior torsion of the glenoid with an average of 16° ± 5°. The values of modified glenoid retroversion were significantly smaller than those of conventional glenoid retroversion in all groups (P < .033), and the values of the modified glenoid inferior inclination were significantly larger than those of conventional glenoid inferior inclination in all groups (P < .001).ConclusionsThe present study showed that the glenoid twists with respect to the scapular body and that modification by glenoid torsion could affect the values of glenoid orientation. These results indicated that glenoid orientation with respect to the glenoid longitudinal axis will help surgeons determine proper placement of the glenoid component during shoulder arthroplasty.
“…4). If the glenoid orientation is not restored during anatomic shoulder arthroplasty, the shear force to the glenoid component might increase 16 . The present results indicate that glenoid orientation should be assessed with respect to the glenoid longitudinal axis in the operative management of asymmetric posteroinferior bone loss of arthritic glenoids.Figure 4( A ) A 68-year-old woman with primary osteoarthritis.…”
Section: Discussionmentioning
confidence: 83%
“…Bouchaib et al 2 evaluated 2-dimensional glenoid version on the reconstructed axial plane perpendicular to the longitudinal axis of the glenoid surface. During shoulder arthroplasty, it is important to recognize the respective glenoid orientation for proper placement of the glenoid component within the glenoid vault 15, 16 , 28, 34. Unless the preoperatively measured values represent proper glenoid orientation, the glenoid would be reconstructed inadequately.…”
BackgroundThe longitudinal axis of the glenoid is not always parallel to the scapular body, and glenoid torsion could affect the values of glenoid orientation. The purpose of this study was to evaluate 3-dimensional glenoid version and inclination modified by glenoid torsion and to clarify the differences between the values of conventional and of modified glenoid orientations.MethodsComputed tomography scans of 30 shoulders without shoulder pathology, 30 shoulders with primary osteoarthritis, and 30 shoulders with a massive rotator cuff tear or cuff tear arthropathy were retrospectively evaluated. After determining the glenoid axis and the scapular planes and calculating conventional glenoid version and inclination, modified glenoid version and inclination, and glenoid torsion, the values of conventional glenoid orientation and those of modified glenoid orientation were compared statistically.ResultsAll shoulders showed anterior torsion of the glenoid with an average of 16° ± 5°. The values of modified glenoid retroversion were significantly smaller than those of conventional glenoid retroversion in all groups (P < .033), and the values of the modified glenoid inferior inclination were significantly larger than those of conventional glenoid inferior inclination in all groups (P < .001).ConclusionsThe present study showed that the glenoid twists with respect to the scapular body and that modification by glenoid torsion could affect the values of glenoid orientation. These results indicated that glenoid orientation with respect to the glenoid longitudinal axis will help surgeons determine proper placement of the glenoid component during shoulder arthroplasty.
“…In shoulders with severe glenohumeral arthritis, the preoperative pathologic features commonly include glenoid retroversion and posterior decentering of the humeral head relative to the glenoid face [9,45,46,53,54]. Surgical treatment of these pathologic features can be a challenge; in their presence glenoid failure attributable to ''rocking horse'' loosening is a concern [17,23,28,50,55,56]. Some authors suggest that glenoid components should be inserted in 15°or less retroversion to avoid inferior outcomes [3,6,10,17,47].…”
“…A 5 -10 threshold was used, as one study analyzing virtual glenoid component insertion identified these as critical values that affect glenoid biomechanics including increased shear force. 23 Additionally, multiple CT-based imaging studies in shoulder arthroplasty have used five degrees as a threshold. 20,24,25 Finally, in order to compare the variability in the differences of the measurements (difference defined as 3D scapula manual measurement-software measurement) between the groups, an F-test was performed.…”
Background Two techniques exist from which all 3D preoperative planning software for total shoulder arthroplasty are based. One technique is based on measurements constructed on the mid-glenoid and scapular landmarks (Landmark). The second is an automated system using a best-fit sphere technique (Automated). The purpose was to compare glenoid measurements from the two techniques against a control computed tomography-derived 3D printed scapula. Methods Computed tomography scans of osteoarthritic shoulders of 20 patients undergoing primary total shoulder arthroplasty were analyzed with both 3D planning software techniques. Measurements from a 3D printed scapula (Scapula) from the true 3D computed tomography scan served as controls. Glenoid version and inclination measurements from each group were blinded and reviewed. Results In 65% (Automated) and 45% (Landmark) of cases, either inclination or version varied by 5° or more versus 3D printed scapula. Significant variability in version differences compared to the scapula group existed (p = 0.007). Glenoid version from the Scapula = 13.0° ± 10.6°, Automated = 15.0° ± 13.9°, and Landmark = 12.2° ± 7.8°. Inclination from Scapula = 5.4° ± 7.9°, Automated = 6.1° ± 12.6°, and Landmark = 6.2° ± 9.1°. Discussion A high percentage of cases showed discrepancies in glenoid inclination and version values from both techniques. Surgeons should be aware that regardless of software technique, there is variability compared to measurements from a control 3D computed tomography printed scapula.
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