Superior glenoid inclination and rotator cuff tears

Chalmers, Peter N.; Beck, Lindsay; Henninger, Heath B.; Tashjian, Robert Z.

doi:10.1016/j.jse.2018.02.043

Cited by 26 publications

(28 citation statements)

References 45 publications

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“…The authors constructed 3D computer models from CT scans (acquired at 0.63 mm slice thickness) of 12 patients scheduled to receive RSA. The 12 shoulders were selected to represent a wide range of CSAs (25°, 30°, 35°, and 40°) with no bony deformity on the scapular or humeral sides, no fractural sequelae only type A1 glenoids according to the classification of Walch et al, 15 and inclination within the range described by Chalmers et al 16 All patients provided written informed consent for the use of their data and images for research and publishing purposes. The CSA was measured on frontal views of the scapula and defined by the angle between the line connecting the superior and inferior poles of the glenoid and the line connecting the lateral edge of the acromion to the inferior pole of the glenoid (Fig.…”

Section: Methodsmentioning

confidence: 99%

Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty

Lädermann

Tay

Collin

et al. 2019

Bone & Joint Research

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Objectives To date, no study has considered the impact of acromial morphology on shoulder range of movement (ROM). The purpose of our study was to evaluate the effects of lateralization of the centre of rotation (COR) and neck-shaft angle (NSA) on shoulder ROM after reverse shoulder arthroplasty (RSA) in patients with different scapular morphologies. Methods 3D computer models were constructed from CT scans of 12 patients with a critical shoulder angle (CSA) of 25°, 30°, 35°, and 40°. For each model, shoulder ROM was evaluated at a NSA of 135° and 145°, and lateralization of 0 mm, 5 mm, and 10 mm for seven standardized movements: glenohumeral abduction, adduction, forward flexion, extension, internal rotation with the arm at 90° of abduction, as well as external rotation with the arm at 10° and 90° of abduction. Results CSA did not seem to influence ROM in any of the models, but greater lateralization achieved greater ROM for all movements in all configurations. Internal and external rotation at 90° of abduction were impossible in most configurations, except in models with a CSA of 25°. Conclusion Postoperative ROM following RSA depends on multiple patient and surgical factors. This study, based on computer simulation, suggests that CSA has no influence on ROM after RSA, while lateralization increases ROM in all configurations. Furthermore, increasing subacromial space is important to grant sufficient rotation at 90° of abduction. In summary, increased lateralization of the COR and increased subacromial space improve ROM in all CSA configurations. Cite this article: A. Lädermann, E. Tay, P. Collin, S. Piotton, C-H Chiu, A. Michelet, C. Charbonnier. Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty. Bone Joint Res 2019;8:378–386. DOI: 10.1302/2046-3758.88.BJR-2018-0293.R1.

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Section: Methodsmentioning

confidence: 99%

Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty

Lädermann

Tay

Collin

et al. 2019

Bone & Joint Research

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“… 2 , 3 , 5 , 9 , 17 , 20 While genetics, 16 , 17 , 19 age, 16 , 17 , 19 and overuse 8 , 22 have all been suggested, osseous morphology may also play a role. 1 , 3 , 5 , 7 , 10 , 11 , 12 Recently, this research has focused on glenoid and acromial morphology including Bigliani type, acromial slope, acromiohumeral distance, lateral acromial angle, acromion index, critical shoulder angle, and glenoid inclication. 1 , 3 , 5 , 7 , 10 , 11 , 12 However, humeral morphology, specifically the morphology of the greater tuberosity may also play a role.…”

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confidence: 99%

Footprint size matters: wider coronal greater tuberosity width is associated with increased rates of healing after rotator cuff repair

et al. 2021

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Background The purpose of this study was to determine whether greater tuberosity morphology (1) could be measured reliably on magnetic resonance imaging (MRI), (2) differed between patients with rotator cuff tears (RCTs) compared with those without tears or glenohumeral osteoarthritis, or (3) differed between patients with rotator cuff repairs (RCR) who healed and those that did not. Methods This is a retrospective comparative study. (1) We measured greater tuberosity width (coronal and sagittal), lateral offset, and angle on MRI corrected into the plane of the humerus. To determine reliability, these measurements were made by two observers and intraclass correlation coefficients were calculated. (2) We compared these measurements between patients with a full-thickness RCT and patients aged >50 years without evidence of a RCT or glenohumeral osteoarthritis. (3) We then compared these measurements between those patients with healed RCRs and those with evidence of retear on MRI. In this portion, we only included patients with both a preoperative and postoperative MRI at least 1 year from RCR. Postoperative MRIs were obtained to assess healing rates, not because of concern for failure. Those without tendon defects were considered healed. Results (1) In a validation cohort of 50 patients with MRI, all inter-rater intraclass correlation coefficients were greater than 0.75. (2) There were no differences between our RCT group of 110 patients and our comparison group of 100 patients in tuberosity coronal width, sagittal width, or lateral offset. The RCT group had a significantly smaller greater tuberosity angle (63 ± 4° vs 65 ± 5°, P = .003). (3) In our group of 110 RCRs, postoperative MRI scans were obtained at a mean follow-up of 23.6 ± 15.7 months showing 84 (76%) patients had healed RCRs. Larger coronal tuberosity width was associated with healing (1.3 ± 0.2 vs 1.2 ± 0.2 cm, P = .032), as was smaller tear width ( P < .001), and retraction ( P < .001). When coronal width was dichotomized, there was a significantly higher healing rate with a width over 1.2 cm (85 vs 66%, P = .02). No other greater tuberosity morphological characteristics were associated with RCR or postoperative healing. Conclusion RCTs do not appear to be associated with greater tuberosity morphology. Postoperative rotator cuff healing based on MRI is 76%. Higher rates of healing occur with a wider coronal tuberosity width (ie, rotator cuff tendon footprint). Consideration could be given to widening the footprint intraoperatively in an effort to improve healing rates although this remains to be validated.

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“…Если же суставной отросток лопатки имеет каудальную инклинацию, то риск переднезаднего смещения головки плечевой кости при вывихе потенциально выше. Краниальная инклинация может быть фактором риска повреждения сухожилия надостной мышцы [18][19][20], а публикации о коррекции верcии суставного отростка посредством корригирующих остеотомий для лечения нестабильности плечевого сустава очень сомнительны с позиции доказанной эффек тивности [21]. В то же время отсутствуют исследования, посвященные изучению особенностей пространственных соотношений костных структур в плечевом суставе у пациентов детского возраста с нестабильностью плечевого сустава.…”

Section: Discussionunclassified

Analysis of roentgenologic parameters of the articular process of the scapula in children with instability of the shoulder joint

Proshchenko

Николаевич²,

Lukyanov

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Background. The frequency of occurrence of dislocation of the shoulder joint is the highest among that for all other limb joints. Simultaneously, recurrent instability of the shoulder joint develops majorly in children and adolescents, which, in the future, lead to the development of persistent pain syndrome. Past evidence indicate that the features of the spatial positioning of the articular process of the scapula can be considered as a risk factor toward the development of instability in the shoulder joint among adult patients. However, there is no reliable data in the literature regarding the influence of tilt and rotation of the shoulder blade glenoid on the occurrence of instability in the shoulder joint among children and adolescents. Encouraged, we undertook this subject for our study. Aim. To clarify the impact of changes in the version and inclination of the glenoid on the instability of the shoulder joint among children. Materials and methods. We analyzed the survey data of 42 children with a habitual dislocation of the shoulder of traumatic and atraumatic origins. The average ages of the examined children were 15.57 1.75 and 15.07 1.64 years, respectively, for those with shoulder instability of traumatic and atraumatic origins, respectively. Results. Statistical data processing revealed no significant differences in the versioning and inclination of the glenoid process between the groups with traumatic and atraumatic instabilities of the shoulder joint. Notably, the average values of versioning and inclination indicators were in the normal range. Conclusion. Based on our results, we suggest that, in the childhood, the dynamic and static soft tissue stabilizers of the shoulder joint play the leading role in the formation of instability of the shoulder joint.

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Superior glenoid inclination and rotator cuff tears

Cited by 26 publications

References 45 publications

Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty

Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty

Footprint size matters: wider coronal greater tuberosity width is associated with increased rates of healing after rotator cuff repair

Analysis of roentgenologic parameters of the articular process of the scapula in children with instability of the shoulder joint

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