Document Detail


Glenoid morphology in reverse shoulder arthroplasty: classification and surgical implications.
MedLine Citation:
PMID:  19482489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A great challenge in reverse shoulder arthroplasty is the wide variation in glenoid morphology that adds uncertainties in glenoid component placement. The purpose of this study was to classify glenoid morphology and examining its effect on possible glenoid component fixation. MATERIALS AND METHODS: The morphology of 216 glenoids was classified into normal and abnormal with subgroups defined by erosion sites. Six anatomic and 2 surgical parameters were compared among the classified groups. Plain radiographs or 2-dimensional (2D) computed tomography (CT) scans showed 62.5% of glenoids were normal and 37.5% were abnormal, with further subclassification of abnormal in posterior (17.6%), superior (9.3%), global (6.5%), and anterior (4.2%) erosions using 3D CT models. RESULTS: The standard centerline became significantly shorter in abnormal (19.6 +/- 9.1 mm) than in normal (28.6 +/- 4.1 mm, P < .0001) glenoids. Alternatively, the spine centerline provided longer bony distance in abnormal glenoids (34.9 +/- 17.0 mm). Abnormal glenoid morphology also reduced peripheral screw placement area by 42% and limited it to the anterior and inferior quadrants. DISCUSSION: Glenoid morphology of the rotator cuff deficient shoulder can be reliably classified using this classification system consisting of normal and abnormal, which included 4 subgroups of posterior, superior, global, and anterior erosions. CONCLUSIONS: Abnormal glenoid morphology was shown to have a significant effect on anatomical and surgical factors which can necessitate adjustments in surgical technique for reverse shoulder arthroplasty. LEVEL OF EVIDENCE: Basic Science Study.
Authors:
Mark A Frankle; Atsushi Teramoto; Zong-Ping Luo; Jonathan C Levy; Derek Pupello
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Publication Detail:
Type:  Journal Article     Date:  2009-05-30
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  18     ISSN:  1532-6500     ISO Abbreviation:  J Shoulder Elbow Surg     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-10-16     Completed Date:  2010-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  874-85     Citation Subset:  IM    
Affiliation:
Florida Orthopaedic Institute, Tampa, FL 33637, USA. frankle@pol.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement / methods*
Female
Humans
Male
Middle Aged
Scapula / anatomy & histology*
Shoulder Joint / anatomy & histology*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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