Top

Surgical and Radiologic Anatomy

Published in:

01-05-2014 | Original Article

Biometrical analysis of the shoulder joint regarding glenoid implant dimensions for arthroplasty

Authors: Jörn Kircher, Bernd Bittersohl, Christoph Zilkens, Achim Hedtmann, Rüdiger Krauspe

Published in: Surgical and Radiologic Anatomy | Issue 4/2014

Abstract

Purpose

Reduced bone stock and difficult intraoperative orientation are challenges in glenoid replacement surgery. New implant designs and methods for fixation, such as locking screws, extra-long central pegs and/or central compression screws are targeting these issues. The objective of this study is the analysis of the glenoid dimension regarding maximum central peg diameter and peg length (PL), and maximum screw length (SL) for glenoid fixation.

Methods

Retrospective analysis of magnetic resonance imaging (n = 50) scans. Measurement of the maximum inferior glenoid diameter (GD), SL, maximum length of a 9.9, 10 and 11.4 mm central peg (PL) in the transverse plane; glenoid version (GV), humeral head diameter (HHD). Two independent measurements.

Results

Mean age: 49.0 ± 15.7 years (17–80) (n = 20 female, 49.6 ± 16.0; n = 30 male, 48.6 ± 15.7). Mean values of measurement were GD: 28.9 ± 3.7 mm (21–39); SL: 34.1 ± 4.9 mm (26–44); PL 9.9 mm: 19.4 ± 4.3 mm (9–30); PL 10 mm: 19.0 ± 4.4 mm (8–30); PL 11.4 mm: 16.5 ± 4.1 mm (7–26) with significant gender differences (p = 0.001; p = 0.022; p = 0.001); GV: −0.6° ± 4.9° (−10 to 11); HHD: 50.0 mm ± 4.9 (41–61). There was good correlation between PL and SL (r = 0.32, p = 0.024) and for GD and PL (r = 0.61, p = 0.001; r = 0.57, p = 0.001; r = 0.96, p = 0.001). The ratio of HHD and GD was very constant with 0.6 ± 0.07.

Conclusions

These data indicate the high interindividual variability of glenoid morphology including significant gender-related differences. The good correlation between humeral head size and GD and maximum central PL can be helpful for cases with reduced bone stock in decision-making about implant size and bone grafting.

Anglin C, Tolhurst P, Wyss UP, Pichora DR (1999) Glenoid cancellous bone strength and modulus. J Biomech 32(10):1091–1097PubMedCrossRef

Bicknell RT, Patterson SD, King GJ, Chess DG, Johnson JA (2007) Glenoid vault endosteal dimensions: an anthropometric study with special interest in implant design. J Should Elb Surg 16(3 Suppl):S96–S101. doi:10.1016/j.jse.2006.03.008 CrossRef

Boileau P, Walch G (1999) Normal and pathological anatomy of the glenoid: effects on the design, preparation and fixation of the glenoid component. In: Walch G, Boileau P (eds) Shoulder arthroplasty, vol 1. Springer, Berlin, pp 127–140CrossRef

Checroun AJ, Hawkins C, Kummer FJ, Zuckerman JD (2002) Fit of current glenoid component designs: an anatomic cadaver study. J Should Elb Surg 11(6):614–617. doi:10.1067/mse.2002.126099 CrossRef

Churchill RS, Brems JJ, Kotschi H (2001) Glenoid size, inclination, and version: an anatomic study. J Should Elb Surg 10(4):327–332. doi:10.1067/mse.2001.115269 CrossRef

Cil A, Veillette CJ, Sanchez-Sotelo J, Sperling JW, Schleck CD, Cofield RH (2010) Survivorship of the humeral component in shoulder arthroplasty. J Should Elb Surg 19(1):143–150. doi:10.1016/j.jse.2009.04.011 CrossRef

Couteau B, Mansat P, Mansat M, Darmana R, Egan J (2001) In vivo characterization of glenoid with use of computed tomography. J Should Elb Surg 10(2):116–122. doi:10.1067/mse.2001.112884 CrossRef

Cyprien JM, Vasey HM, Burdet A, Bonvin JC, Kritsikis N, Vuagnat P (1983) Humeral retrotorsion and glenohumeral relationship in the normal shoulder and in recurrent anterior dislocation (scapulometry). Clin Orthop Relat Res 175:8–17PubMed

De Wilde L, Defoort S, Verstraeten TR, Speeckaert W, Debeer P (2012) A 3D-CT scan study of the humeral and glenoid planes in 150 normal shoulders. Surg Radiol Anat 34(8):743–750. doi:10.1007/s00276-011-0836-4 PubMedCrossRef

10.

Deutsch A, Abboud JA, Kelly J, Mody M, Norris T, Ramsey ML, Iannotti JP, Williams GR (2007) Clinical results of revision shoulder arthroplasty for glenoid component loosening. J Should Elb Surg 16(6):706–716. doi:10.1016/j.jse.2007.01.007 CrossRef

11.

Edelson JG (1995) Localized glenoid hypoplasia. An anatomic variation of possible clinical significance. Clin Orthop Relat Res 321:189–195PubMed

12.

Friedman RJ, Hawthorne KB, Genez BM (1992) The use of computerized tomography in the measurement of glenoid version. J Bone Jt Surg (A) 74(7):1032–1037

13.

Habermeyer P, Kircher J (2010) Standardendoprothetik. In: Habermeyer P, Lichtenberg S, Magosch P (eds) Schulterchirurgie, 4th edn. Elsevier/Urban & Fischer, München, pp 655–745

14.

Iannotti JP, Gabriel JP, Schneck SL, Evans BG, Misra S (1992) The normal glenohumeral relationships. An anatomical study of one hundred and forty shoulders. J Bone Jt Surg (A) 74(4):491–500

15.

Inui H, Sugamoto K, Miyamoto T, Machida A, Hashimoto J, Nobuhara K (2001) Evaluation of three-dimensional glenoid structure using MRI. J Anat 199(Pt 3):323–328PubMedCentralPubMedCrossRef

16.

Jeske HC, Oberthaler M, Klingensmith M, Dallapozza C, Smekal V, Wambacher M, Kralinger F (2009) Normal glenoid rim anatomy and the reliability of shoulder instability measurements based on intrasite correlation. Surg Radiol Anat 31(8):623–625. doi:10.1007/s00276-009-0492-0 PubMedCrossRef

17.

Kircher J, Morhard M, Gavriilidis I, Magosch P, Lichtenberg S, Habermeyer P (2010) Is there an association between a low acromion index and osteoarthritis of the shoulder? Int Orthop 34–7:1005–1010CrossRef

18.

Kircher J, Morhard M, Magosch P, Ebinger N, Lichtenberg S, Habermeyer P (2010) How much are radiological parameters related to clinical symptoms and function in osteoarthritis of the shoulder? Int Orthop 34(5):677–681. doi:10.1007/s00264-009-0846-6 PubMedCentralPubMedCrossRef

19.

Kraljevic M, Zumstein V, Hugli R, Muller-Gerbl M (2013) A comparison of subchondral bone mineralization between the glenoid cavity and the humeral head on 57 cadaverous shoulder joints. Surg Radiol Anat 35(4):295–300. doi:10.1007/s00276-012-1034-8 PubMedCrossRef

20.

Mallon WJ, Brown HR, Vogler JB 3rd, Martinez S (1992) Radiographic and geometric anatomy of the scapula. Clin Orthop Relat Res 277:142–154PubMed

21.

Melis B, Bonnevialle N, Neyton L, Levigne C, Favard L, Walch G, Boileau P (2012) Glenoid loosening and failure in anatomical total shoulder arthroplasty: is revision with a reverse shoulder arthroplasty a reliable option? J Should Elb Surg 21(3):342–349. doi:10.1016/j.jse.2011.05.021 CrossRef

22.

Merrill A, Guzman K, Miller SL (2009) Gender differences in glenoid anatomy: an anatomic study. Surg Radiol Anat 31(3):183–189. doi:10.1007/s00276-008-0425-3 PubMedCrossRef

23.

Miyazaki AN, Itoi E, Sano H, Fregoneze M, Santos PD, da Silva LA, Sella Gdo V, Martel EM, Debom LG, Andrade ML, Checchia SL (2011) Comparison between the acromion index and rotator cuff tears in the Brazilian and Japanese populations. J Should Elb Surg 20(7):1082–1086. doi:10.1016/j.jse.2011.04.028 CrossRef

24.

Mullaji AB, Beddow FH, Lamb GH (1994) CT measurement of glenoid erosion in arthritis. J Bone Jt Surg Br 76(3):384–388

25.

Namdari S, Goel DP, Romanowski J, Glaser D, Warner JJ (2011) Principles of glenoid component design and strategies for managing glenoid bone loss in revision shoulder arthroplasty in the absence of infection and rotator cuff tear. J Should Elb Surg 20(6):1016–1024. doi:10.1016/j.jse.2011.03.016 CrossRef

26.

Putz R, Müller-Gerbl M (2010) Topografie und funktionelle Anatomie des Schultergürtels und des Schultergelenkes. In: Habermeyer P, Lichtenberg S, Magosch P (eds) Schulterchirurgie, 4th edn. Elsevier/Urban & Fischer, München, pp 2–20

27.

Randelli M, Gambrioli PL (1986) Glenohumeral osteometry by computed tomography in normal and unstable shoulders. Clin Orthop Relat Res 208:151–156PubMed

28.

Scalise JJ, Codsi MJ, Bryan J, Iannotti JP (2008) The three-dimensional glenoid vault model can estimate normal glenoid version in osteoarthritis. J Should Elb Surg 17(3):487–491. doi:10.1016/j.jse.2007.09.006 CrossRef

29.

van de Sande MA, Brand R, Rozing PM (2006) Indications, complications, and results of shoulder arthroplasty. Scand J Rheumatol 35(6):426–434PubMedCrossRef

30.

von Schroeder HP, Kuiper SD, Botte MJ (2001) Osseous anatomy of the scapula. Clin Orthop Relat Res 383:131–139CrossRef

31.

Wirth MA, Lyons FR, Rockwood CA Jr (1993) Hypoplasia of the glenoid. A review of sixteen patients. J Bone Jt Surg (A) 75(8):1175–1184

Title: Biometrical analysis of the shoulder joint regarding glenoid implant dimensions for arthroplasty
Authors: Jörn Kircher
Bernd Bittersohl
Christoph Zilkens
Achim Hedtmann
Rüdiger Krauspe
Publication date: 01-05-2014
Publisher: Springer Paris
Published in: Surgical and Radiologic Anatomy / Issue 4/2014
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-013-1197-y

At a glance: The STEP trials

Springer Medicine

Biometrical analysis of the shoulder joint regarding glenoid implant dimensions for arthroplasty

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2014

High and dehiscent jugular bulb: clear and present danger during middle ear surgery

Functional lengths of the lower limb arterial tree measured by CT angiography centreline analysis: implications for catheter lengths in peripheral angioplasty

Thickness distribution of the glenohumeral joint cartilage: a quantitative study using computed tomography

Size and location of thyroid gland in the fetal period

Bilateral bifid ureter with unilateral renal vasculature variations

Arthroscopy of the sternoclavicular joint: an anatomic evaluation of structures at risk