Classification of humeral head pathomorphology in primary osteoarthritis: a radiographic and in vivo photographic analysis

Habermeyer, Peter; Magosch, Petra; Weiß, Christel; Hawi, Nael; Lichtenberg, Sven; Tauber, Mark; Ipach, Bastian

doi:10.1016/j.jse.2017.07.009

Cited by 21 publications

(38 citation statements)

References 16 publications

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“…The magnitude of this described elliptical shape of the native humeral head may be increased in further progression of high-grade OA. This was confirmed clinically by Habermeyer et al [7], who found that 82.2% of patients who underwent anatomic shoulder arthroplasty for treatment of primary OA had an aspherical humeral head shape. These observations also implied that 17.8% of the evaluated humeral heads were still spherical in shape, bringing greater confusion as to which patient would most benefit more from a spherical head design rather than from an elliptical one.…”

Section: Discussionmentioning

confidence: 54%

“…However, several recent anatomic studies have described the humeral head to be more elliptical in shape, rather than a perfect sphere [ 7 , 12 , 16 ]. These studies have reported that the humeral head diverges to elliptical in the anterior–posterior dimension at the periphery of the articular margin, having roughly an 8–12% difference in head radius when comparing frontal and sagittal planes [ 12 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Rotational range of motion of elliptical and spherical heads in shoulder arthroplasty: a dynamic biomechanical evaluation

Muench

Otto

Kia

et al. 2020

Arch Orthop Trauma Surg

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Introduction Elliptical shape humeral head prostheses have been proposed to reflect a more anatomic shoulder replacement. Its effect on the rotational range of motion (ROM) compared to a standard spherical head is still not understood. The purpose was to investigate if there would be a difference in rotational ROM when comparing elliptical and spherical prosthetic heads in a dynamic shoulder model. The authors hypothesized that the use of elliptical heads would result in significantly more rotational ROM compared to the spherical head design. Materials and methods Six fresh-frozen, cadaveric shoulders were evaluated using a dynamic shoulder model. After being tested in the native condition, each specimen underwent 6 conditions in the hemiarthroplasty state: (1) matched-fit spherical head, (2) oversized spherical head, (3) undersized spherical head, (4) matched-fit elliptical head, (5) oversized elliptical head, and (6) undersized elliptical head. Following conversion to total shoulder arthroplasty (TSA), the 6 prior conditions were rerun. Each condition was tested at 0°, 30° and 60° of glenohumeral abduction. Rotational ROM was quantified using 3-dimensional tracking, while dynamically applying alternating forces for internal and external rotation via the rotator cuff tendons. Results Elliptical and spherical prosthetic heads showed no significant difference in the degree of the total, internal, and external rotational ROM for both the hemiarthroplasty and TSA state. Conversion from hemiarthroplasty to TSA resulted in less degree of total rotational ROM for both head designs in all abduction positions, without reaching statistical significance. There was a significant decrease in total, internal, and external rotational ROM for both elliptical and spherical heads in every replacement condition, when comparing 0° to 30° and 60° of abduction (P < 0.05, respectively). Conclusion In a dynamic shoulder model, elliptical and spherical prosthetic head designs showed no significant difference in the degree of the total, internal, and external rotational ROM in both the hemiarthroplasty and TSA state. Level of evidence Controlled laboratory study

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Rotational range of motion of elliptical and spherical heads in shoulder arthroplasty: a dynamic biomechanical evaluation

Muench

Otto

Kia

et al. 2020

Arch Orthop Trauma Surg

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“…Although biomechanical studies have shown that the glenoid design is critical for initial fixation strength [29], clinical and radiographic studies demonstrating the superiority of one design over another are yet to be reported [28,29]. More importantly, the inconsistency of clinical findings along with recent anatomic studies describing the humeral head to be rather elliptical in shape than a perfect sphere may imply that the design of the humeral head prosthesis may also have a considerable influence on the long-term stability of the glenoid component [8,11,[13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Elliptical heads result in increased glenohumeral translation along with micro-motion of the glenoid component during axial rotation in total shoulder arthroplasty

Muench

Kia

Murphey

et al. 2021

Arch Orthop Trauma Surg

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Introduction Elliptical-shaped humeral head prostheses have recently been proposed to reflect a more anatomic shoulder replacement. However, its subsequent effect on micro-motion of the glenoid component is still not understood. Materials and methods Six fresh-frozen, cadaveric shoulders (mean age: 62.7 ± 9.2 years) were used for the study. Each specimen underwent total shoulder arthroplasty using an anatomic stemless implant. At 15°, 30°, 45° and 60° of glenohumeral abduction, 50° of internal and external rotations in the axial plane were alternatingly applied to the humerus with both an elliptical and spherical humeral head design. Glenohumeral translation was assessed by means of a 3-dimensional digitizer. Micro-motion of the glenoid component was evaluated using four high-resolution differential variable reluctance transducer strain gauges, placed at the anterior, posterior, superior, and inferior aspect of the glenoid component. Results The elliptical head design showed significantly more micro-motion in total and at the superior aspect of glenoid component during external rotation at 15° (total: P = 0.004; superior: P = 0.004) and 30° (total: P = 0.045; superior: P = 0.033) of abduction when compared to the spherical design. However, during internal rotation, elliptical and spherical heads showed similar amounts of micro-motion at the glenoid component at all tested abduction angles. When looking at glenohumeral translation, elliptical and spherical heads showed similar anteroposterior and superoinferior translation as well as compound motion during external rotation at all tested abduction angles. During internal rotation, the elliptical design resulted in significantly more anteroposterior translation and compound motion at all abduction angles when compared to the spherical design (P < 0.05). Conclusion In the setting of total shoulder arthroplasty, the elliptical head design demonstrated greater glenohumeral translation and micro-motion at the glenoid component during axial rotation when compared to the spherical design, potentially increasing the risk for glenoid loosening in the long term. Level of evidence Controlled Laboratory Study

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“…b) and coronal (Fig. c) T1 sequences, similar to the method described on radiographs by Habermeyer et al (Habermeyer et al, ). The coronal measurement was considered positive if the apex of the humeral head was lateral to the midpoint of the acromion and negative if medial.…”

Section: Methodsmentioning

confidence: 97%

Shoulder measurements on MRI: Statistical analysis of patients without and with rotator cuff tears and predictive modeling

2019

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This study aims to determine significant differences between various measurements of shoulder structures and relationships in patients with and without rotator cuff tears and identify a subset of these measurements that may merit further investigation. Shoulder MRIs of 120 patients with rotator cuff tears (RCT group) and 80 patients with normal examinations (No RCT group) were retrospectively identified. Numerous measurements of shoulder anatomy and relationships and pathology characterization were performed for each study. The mean and ranges of measurements for each group were identified, and P-values were calculated to assess differences between the two groups. Classification and Regression Tree (CART) identified prediction models for separating the two groups based on these shoulder MRI measurements. Statistically significant differences were observed for 9 of 18 of the shoulder measurements between the two groups (P < 0.05). Using long head of biceps tendon tear, tendinosis, and subacromial-subdeltoid bursal fluid, the prediction model from CART demonstrated 99.5% accuracy in separating the two groups. Subacromial distance, subacromial spur size, and acromioclavicular osteophyte could also separate the two groups with 97.5% accuracy. Other measures less commonly associated with impingement and rotator cuff tears could also be used to separate the two groups with up to 81.5% accuracy. This study introduces new measures and clarifies ranges for existing measurements on shoulder MRI. Abnormalities of some of these measurements may be associated with subacromial impingement, and combinations of these parameters may be useful for separating patients with or without rotator cuff tears. Clin. Anat. 33:173-186, 2020.

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Classification of humeral head pathomorphology in primary osteoarthritis: a radiographic and in vivo photographic analysis

Cited by 21 publications

References 16 publications

Rotational range of motion of elliptical and spherical heads in shoulder arthroplasty: a dynamic biomechanical evaluation

Rotational range of motion of elliptical and spherical heads in shoulder arthroplasty: a dynamic biomechanical evaluation

Elliptical heads result in increased glenohumeral translation along with micro-motion of the glenoid component during axial rotation in total shoulder arthroplasty

Shoulder measurements on MRI: Statistical analysis of patients without and with rotator cuff tears and predictive modeling

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