The Glenoid Vault Outer Cortex a new more accurate radiological reference for shoulder arthroplasty

Abstract

Introduction: Correct positioning of the glenoid component is an important determinant of outcome in shoulder arthroplasty. We describe and assess a new radiological plane of reference for improving the accuracy of glenoid preparation prior to component implantation – the Glenoid Vault Outer Cortex (GvOC) plane. Methods: One hundred and five CT scans of normal scapulae were obtained. Forty six females and 59 males aged between 22 and 30 years. The accuracy of the GvOC plane was then compared against the current “gold standard” – the scapular border (SB). Measurements of glenoid inclination, version, rotation, and offset were obtained using both the GvOC and SB planes. These were then compared to actual values. Results: The mean difference between version obtained using the GvOC plane and the actual value was 1.8° (−2 to 5, SD 1.6) as compared to 6.7° (−2 to 17, SD 4.3) when the SB plane was used, (p < 0.001). The mean difference between estimates of inclination obtained using the GvOC plane and the actual were 1.9° (−4 to 6, SD 1.6) as compared to 11.2° (−4 to 25, SD 6.1) when the SB plane was used, (p < 0.001). Conclusions: The GvOC plane produced estimates of glenoid version and inclination closer to actual values with lower variance than when the SB plane was used. The GvOC may be a more accurate and reproducible radiological method for surgeons to use when defining glenoid anatomy prior to arthroplasty surgery.

Mid-term Results Following Reverse Shoulder Arthroplasty and the Role of Navigation in the Management of Glenoid Bone Loss

“…Among the most well-described prognostic factors predisposing to early failure of the reverse shoulder replacement is the poor positioning of the glenoid component [17]. Positioning the glenoid component in excessive superior inclination can lead to detrimental effects such as scapular notching, medial polyethylene wear, scapular impingement, and, as a result, early aseptic loosening of the implant [18,19].…”

Pre-operative planning for reverse shoulder arthroplasty in low-resource centres: A modified Delphi study in South Africa

“…Glenoid wear and structural defects necessitating intervention have been documented in approximately 15% of shoulders undergoing arthroplasty [1]. Effective preoperative planning is challenging and crucial to enhance procedural efficacy and optimize surgical outcomes in patients undergoing reverse shoulder arthroplasty (RSA) [2]. The first steps of planning shoulder arthroplasty encompass patient history taking, clinical examination and plain X-rays with Grashey views, however, computed tomography (CT) scan with 3D reconstructions are recommended for evaluation of glenoid morphology [3].…”

Preoperative planning to preserve glenoid subchondral bone in anatomical total shoulder replacement

“…The reliance on scapula shape and landmarks using the scapula blade has been questioned with interest in external and internal glenoid vault anatomy. 2 , 13 , 23 Preparation of the glenoid involves determining the alignment of the implantation by comparing the position of a guidewire using scapula reference points.…”