Standard radiological classification of glenohumeral osteoarthritis does not correlate with the complexity of the arthritic glenoid deformity

Linke, Philip; Zemke, Katrin; Ecker, Niklas Unter; Neumann, Joerg; Werner, A.

doi:10.1007/s00402-021-03758-7

Cited by 6 publications

(12 citation statements)

References 34 publications

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“…Since many these factors have been shown to complicate surgical treatment or compromise clinical results, the further differentiation of the former grade III into grades III and IV is strongly recommended to allow a better estimation of following procedures and outcomes when assessing humeral osteoarthritis.V. 14 Besides the present study, Linke et al 17 were the only group assessing the relationship between humeral and glenoid OA in patients with primary glenohumeral OA undergoing TSA. Patients and methods differed substantially from our study.…”

Section: Discussionmentioning

confidence: 73%

“…Contrary to the extent of research on humeral OA and glenoid morphology, the reliability for humeral OA by using the respective classification is high, 15 - 17 while agreement on glenoid morphology may be as low as fair. 18 - 21 In this case, HH characteristics implying information about glenoid morphology could be valuable for treatment decisions and prognosis.…”

Section: Introductionmentioning

confidence: 93%

“…3,11,12 On the humeral side, the Samilson-Prieto classification 13 was originally used for instability OA. Based on this classification, Habermeyer et al 14 Contrary to the extent of research on humeral OA and glenoid morphology, the reliability for humeral OA by using the respective classification is high, [15][16][17] while agreement on glenoid morphology may be as low as fair. [18][19][20][21] In this case, HH characteristics implying information about glenoid morphology could be valuable for treatment decisions and prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Is there a correlation between humeral osteoarthritis and glenoid morphology according to Walch?

Vetter¹,

Magosch

Habermeyer

2022

Bone & Joint Open

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Aims The aim of this study was to determine whether there is a correlation between the grade of humeral osteoarthritis (OA) and the severity of glenoid morphology according to Walch. We hypothesized that there would be a correlation. Methods Overal, 143 shoulders in 135 patients (73 females, 62 males) undergoing shoulder arthroplasty surgery for primary glenohumeral OA were included consecutively. Mean age was 69.3 years (47 to 85). Humeral head (HH), osteophyte length (OL), and morphology (transverse decentering of the apex, transverse, or coronal asphericity) on radiographs were correlated to the glenoid morphology according to Walch (A1, A2, B1, B2, B3), glenoid retroversion, and humeral subluxation on CT images. Results Increased humeral OL correlated with a higher grade of glenoid morphology (A1-A2-B1-B2-B3) according to Walch (r = 0.672; p < 0.0001). It also correlated with glenoid retroversion (r = 0.707; p < 0.0001), and posterior humeral subluxation ( r = 0.452; p < 0.0001). A higher humeral OL (odds ratio (OR) 1.17; 95% confidence interval (CI) 1.03 to 1.32; p = 0.013), posterior humeral subluxation (OR 1.11; 95% CI 1.01 to 1.22; p = 0.031), and glenoid retroversion (OR 1.48; 95% CI 1.30 to 1.68; p < 0.001) were independent factors for a higher glenoid morphology. More specifically, a humeral OL of ≥ 13 mm was indicative of eccentric glenoid types B2 and B3 (OR 14.20; 95% CI 5.96 to 33.85). Presence of an aspherical HH in the coronal plane was suggestive of glenoid types B2 and B3 (OR 3.34; 95% CI 1.67 to 6.68). Conclusion The criteria of humeral OL and HH morphology are associated with increasing glenoid retroversion, posterior humeral subluxation, and eccentric glenoid wear. Therefore, humeral radiological parameters might hint at the morphology on the glenoid side. Cite this article: Bone Jt Open 2022;3(6):463–469.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Is there a correlation between humeral osteoarthritis and glenoid morphology according to Walch?

Vetter¹,

Magosch

Habermeyer

2022

Bone & Joint Open

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“…Therefore, understanding glenoid morphology in the axial plane is mandatory in the final stage of OA for correct implant selection. However, no validated classification has been published to assess Dislocation Arthropathy in the axial plane [ 17 ].…”

Section: Classificationmentioning

confidence: 99%

Dislocation Arthropathy of the Shoulder

Coifman

Brunner

Scheibel

2022

JCM

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Glenohumeral osteoarthrosis (OA) may develop after primary, recurrent shoulder dislocation or instability surgery. The incidence is reported from 12 to 62%, depending on different risk factors. The risk of severe OA of the shoulder following dislocation is 10 to 20 times greater than the average population. Risk factors include the patient’s age at the first episode of instability or instability surgery, bony lesions, and rotator cuff tears. For mild stages of OA, arthroscopic removal of intraarticular material, arthroscopic debridement, or arthroscopic arthrolysis of an internal rotation contracture might be sufficient. For severe stages, mobilization of the internal rotation contracture and arthroplasty is indicated. With an intact rotator cuff and without a bone graft, results for anatomical shoulder arthroplasty are comparable to those following primary OA. With a bone graft at the glenoidal side, the risk for implant loosening is ten times greater. For the functional outcome, the quality of the rotator cuff is more predictive than the type of the previous surgery or the preoperative external rotation contracture. Reverse shoulder arthroplasty could be justified due to the higher rate of complications and revisions of non-constrained anatomic shoulder arthroplasties reported. Satisfactory clinical and radiological results have been published with mid to long term data now available.

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“…Although the KL system is not exclusive to the GH joint, it is a widely accepted tool to standardize the interpretation of arthritis 27 . The SP classification system was originally designed for GH dislocation joint arthropathy but was later revised for general assessment of GH arthritis and remains a favorable tool, given its high interobserver reliability 28 . However, both SP and KL classification systems have conflicting evidence, suggesting they may underestimate the complexity of disease with poor correlation to the degree of glenoid deformity and humeral head subluxation found on CT imaging 27,28 .…”

Section: X-raymentioning

confidence: 99%

Diagnosis and Management of Glenohumeral Arthritis in the Active Adult

Garvick

Bates

Jensen

et al. 2022

JBJS Journal of Orthopaedics for Physician Assistants

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Glenohumeral arthritis can significantly impact quality of life, most notable in highly active patients. A linear approach to management based on age alone negates factors that impact patient goals such as pain control, joint function, and joint preservation. Diagnostics should use X-ray, computed tomography, and magnetic resonance imaging to provide information about severity of disease and inform treatment plans, including surgical approaches. Although surgical intervention in young adults has previously been controversial, after nonoperative interventions, such as medications, physical therapy, and intra-articular injections, have failed, many studies support arthroplasty to control pain and maximize function throughout their life span.

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Standard radiological classification of glenohumeral osteoarthritis does not correlate with the complexity of the arthritic glenoid deformity

Cited by 6 publications

References 34 publications

Is there a correlation between humeral osteoarthritis and glenoid morphology according to Walch?

Is there a correlation between humeral osteoarthritis and glenoid morphology according to Walch?

Dislocation Arthropathy of the Shoulder

Diagnosis and Management of Glenohumeral Arthritis in the Active Adult

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