Reliability analysis of glenoid component inclination measurements on postoperative radiographs and computed tomography–based 3D models in total and reversed shoulder arthroplasty patients

Haver, Annemieke Van; Heylen, Steven; Vuylsteke, Kristien; Declercq, G; Verborgt, Olivier

doi:10.1016/j.jse.2015.09.003

Cited by 24 publications

(23 citation statements)

References 26 publications

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“…Furthermore, remnants of cartilage present on the extracted scapulae may account for these observed differences. Nevertheless, the difference between our morphological and radiological measurements was within a similar order of magnitude as reported for 2D- and 3D-CT measurements, with a range for the glenoid version angle of 0.1°–23°, and for the inclination angle of 0.2°–4.5° [12–15, 52, 60, 61]. …”

Section: Discussionsupporting

confidence: 82%

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

Mathews

Burkhard

Serrano

et al. 2017

BMC Musculoskelet Disord

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BackgroundPlacement of the glenoid baseplate is of paramount importance for the outcome of anatomical and reverse total shoulder arthroplasty. However, the database around glenoid size is poor, particularly regarding small scapulae, for example, in women and smaller individuals, and is derived from different methodological approaches. In this multimodality cadaver study, we systematically examined the glenoid using morphological and 3D-CT measurements.MethodsMeasurements of the glenoid and drill hole tunnel length for superior baseplate screw placement were recorded to define size of the glenoid and the distance to the scapular notch on cadaveric specimens. Glenoid angles were determined on both, 3D-CT-scans of the thoraxes using the Friedman method and on subsequently isolated scapulae from 18 male and female donors (average 84 years, range 60–98 years).ResultsMean glenoid height was 36.6 mm ± 3.6, and width 27.8 mm ± 3.1 with a significant sex dimorphism (p ≤ 0.001): in males, glenoid height 39.5 mm ± 3.5, and width 30.3 mm ± 3.3, and in females, glenoid height 34.8 mm ± 2.2, and width 26.2 mm ± 1.6. The average distance from the superior screw entry to its exit in the scapular notch measured by calliper was 27.2 mm ± 6.0 with a sex difference: in males, 29.4 mm ± 5.7, and in females, 25.8 mm ± 5.9 mm with a minimum recorded distance of 15 mm. Measured by CT, the mean inclination angle for male and female donors combined was 13.0° ± 7.0, and the ante-/retroversion angle −1.0° ± 4.0°.ConclusionThis study is one of the first to combine dissection, including drill holes, with anatomical measurements and radiological data. In some women and smaller individuals, smaller baseplates should be selected. The published safe zone of 20 mm is generally feasible for superior screw placement, however, in small patients this distance may be substantially shorter than expected and start as of 13 and 15 mm, respectively. No correlation between glenoid height or width with the length of our drilling canal towards the scapular notch was found. Preoperative CT-based treatment planning to determine version and inclination angles is recommended.

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Section: Discussionsupporting

confidence: 82%

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

Mathews

Burkhard

Serrano

et al. 2017

BMC Musculoskelet Disord

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“…Moreover, from a biomechanical point of view, the supraspinatus fossa line indicates the line of action of the rotator cuff muscles. 37 Therefore, the goal of preoperative planning in RSA should be to obtain an RSA angle measurement close to 0 (ie, to implant the baseplate in neutral inclination): In such a configuration, the vectors of the remaining cuff muscles are orthogonal and potentially more efficient. 15,21,22,37 Many techniques have been described to correct the superior glenoid inclination when performing an RSA.…”

Section: Discussionmentioning

confidence: 99%

“…37 Therefore, the goal of preoperative planning in RSA should be to obtain an RSA angle measurement close to 0 (ie, to implant the baseplate in neutral inclination): In such a configuration, the vectors of the remaining cuff muscles are orthogonal and potentially more efficient. 15,21,22,37 Many techniques have been described to correct the superior glenoid inclination when performing an RSA. 25,31 One of the more common techniques involves eccentric reaming inferiorly (to obtain the subchondral ''smiley face''), with an inferiorly angled guide pin.…”

Section: Discussionmentioning

confidence: 99%

“…28 The supraspinatus fossa line, defined in 3D as the best-fit line in the deepest part of this fossa, was used as a reference line. 37 Three independent observers measured these angles on plain AP radiographs and CT scans. Inter-rater reliability was assessed Figure 2 Measurements of total shoulder arthroplasty (TSA) angle (A) and reverse shoulder arthroplasty (RSA) angle (B) on plain anteroposterior radiographs.…”

Section: Radiographic Parametersmentioning

confidence: 99%

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The reverse shoulder arthroplasty angle: a new measurement of glenoid inclination for reverse shoulder arthroplasty

Boileau¹,

Gauci²,

Wagner

et al. 2019

Journal of Shoulder and Elbow Surgery

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Background: Avoiding superior inclination of the glenoid component in reverse shoulder arthroplasty (RSA) is crucial. We hypothesized that superior inclination was underestimated in RSA. Our purpose was to describe and assess a new measurement of inclination for the inferior portion of the glenoid (where the baseplate rests). Methods: The study included 47 shoulders with rotator cuff tear arthropathy (mean age, 76 years). The reverse shoulder arthroplasty angle (RSA angle), defined as the angle between the inferior part of the glenoid fossa and the perpendicular to the floor of the supraspinatus, was compared with the global glenoid inclination (b angle or total shoulder arthroplasty [TSA] angle). Measurements were made on plain anteroposterior radiographs and reformatted 2dimensional (2D) computed tomography (CT) scans by 3 independent observers and compared with 3-dimensional (3D) software (Glenosys) measurements. Results: The mean RSA angle was 25 AE 8 on plain radiographs, 20 AE 6 on reformatted 2D CT scans, and 21 AE 5 via 3D reconstruction software. The mean TSA angle was on average 10 AE 5 lower than the mean RSA angle (P < .001); this difference was observed regardless of the method of measurement (radiographs, 2D CT, or 3D CT) and type of glenoid erosion according to Favard. In Favard type E1 glenoids with central concentric erosion, the difference between the 2 angles was 12 AE 4 (P < .001). Conclusion: The same angle cannot be used to measure glenoid inclination in anatomic and reverse prostheses. The TSA (or b) angle underestimates the superior orientation of the reverse baseplate in RSA. The RSA angle (20 AE 5) needs to be corrected to achieve neutral inclination of the baseplate (RSA angle ¼ 0). Surgeons should be aware that E1 glenoids (with central erosion) are at risk for baseplate superior tilt if the RSA angle is not corrected.

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“…2,6,18,21,31,34 These techniques have poor reliability as a result of variations in the gantry angle at the time of CT or plain-film acquisition. 3,7,17,22,23,27,29 In contrast, 2D measurements in which the 2D images are first corrected to the plane of the scapula by 3-dimensional (3D) reconstruction have shown lower variability. 4,7,16,20 Nevertheless, with this method, we still have to choose a certain 2D slice for measurements.…”

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confidence: 99%

Can the contralateral scapula be used as a reliable template to reconstruct the eroded scapula during shoulder arthroplasty?

Verhaegen

Plessers

Verborgt

et al. 2018

Journal of Shoulder and Elbow Surgery

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Reliability analysis of glenoid component inclination measurements on postoperative radiographs and computed tomography–based 3D models in total and reversed shoulder arthroplasty patients

Cited by 24 publications

References 26 publications

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors

The reverse shoulder arthroplasty angle: a new measurement of glenoid inclination for reverse shoulder arthroplasty

Can the contralateral scapula be used as a reliable template to reconstruct the eroded scapula during shoulder arthroplasty?

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