Restoration of glenoid joint line: a three-dimensional analysis of scapular landmarks

The Use of Glenoid Structural Allografts for Glenoid Bone Defects in Reverse Shoulder Arthroplasty

“…Preoperative planning with metal artifact subtraction software was essential to understand the bony defect and to plan the graft accordingly. Both mirroring and overlaying of the patient's contralateral scapula onto the pathological glenoid or the generation of an algorithm-based premorbid prediction via SSM were valid methods used to identify the glenoid bone defect [12]. Also, identification of the premorbid joint line via these methods allowed a pre-planned amount of lateralization to be incorporated into the graft size [16].…”

“…The presence of glenoid erosion usually causes medialization of the glenoid articulating surface, subsequently medializing the joint line as well. This negatively impacts soft tissue tension and joint reaction forces [12]. Hence, it is the technical aim of many surgeons to restore the premorbid version and glenoid joint line.…”

“…Benefits include increased stability of implants, restoration of soft tissue tension, and greater range of postoperative movement [13]. It is known that the normal glenoid joint line is, on average, 28.36 mm from the scapular notch and 11.66 mm from the centre of the coracoid [12]. The average medialization from the paleoglenoid rim to the neoglenoid base of a B2 glenoid measured on a three-dimensional (3D) computed tomography (CT) scan is, on average, 4 mm [14].…”

“…The importance of internal and external rotational activities for individual patients may also influence version choice. Whatever the surgical goal, knowing the native glenoid version and inclination will assist in planning the optimum position [2,12,19].…”