Advertisement

A new geometric model to quantify the area of glenoid bone defect and medialisation of the native joint line in glenohumeral arthritis

  • Riccardo Maria LanzettiEmail author
  • Marco Spoliti
Original Article • SHOULDER - ARTHROPLASTY
  • 21 Downloads

Abstract

Purpose

To propose a geometric model to quantify the bone defect and the glenoid medialisation (in millimetres) compared to the native joint line. We also evaluated the reliability of this geometric model.

Methods

Using two-dimensional CT imaging, we built a hypothetical triangle on the axial scan consisting of the following: side A, length (millimetres) of the glenoid bone; side B, average length (millimetres) of the glenoid in a healthy population; side C, the missing side; and angle α, the retroversion angle calculated using the Friedman method. The resulting triangle represents the bone defect, and its height represents the medialisation of the native joint line. To estimate inter-operator reliability, two physicians (operator 1 and operator 2) took the following measurements: angle α, side A, side C, semi-perimeter, area defect and height.

Results

Forty participants (mean age ± SD 45 ± 10 years, range 26–43 years)—22 women and 18 men—participated in the study. We applied the cosine theorem (Carnot theorem) to calculate side C. After obtaining the three sides, the area of the triangle can be determined. Once the area is known, it is possible to extrapolate the height of the triangle, which corresponds to the loss of vault depth due to the bone defect. With respect to inter-operator reliability, the ICCs for all measurements were > 0.99, exhibiting a very high correlation.

Conclusions

The proposed geometric model can be used to quantify the glenoid bone deficit and the glenoid medialisation compared to the native joint line, which can be used to improve surgical treatment.

Keywords

Shoulder Reverse arthroplasty Glenoid Bone graft Bone loss 

Notes

Compliance with ethical standards

Conflict of interest

Riccardo Maria Lanzetti and Marco Spoliti have no conflict of interest.

References

  1. 1.
    Adams JE, Sperling JW, Hoskin TL, Melton LJ 3rd, Cofield RH (2006) Shoulder arthroplasty in Olmsted County, Minnesota, 1976–2000: a population-based study. J Shoulder Elbow Surg 15(1):50–55CrossRefPubMedGoogle Scholar
  2. 2.
    DeFrances CJ, Lucas CA, Buie VC, Golosinskiy A (2008) 2006 National Hospital discharge survey. Natl Health Stat Rep 30(5):1–20Google Scholar
  3. 3.
    Kim SH, Wise BL, Zhang Y, Szabo RM (2011) Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am 93(24):2249–2254CrossRefPubMedGoogle Scholar
  4. 4.
    Frankle MA, Teramoto A, Luo ZP, Levy JC, Pupello D (2009) Glenoid morphology in reverse shoulder arthroplasty: classification and surgical implications. J Shoulder Elbow Surg 18:874–885CrossRefPubMedGoogle Scholar
  5. 5.
    Favre P, Sussmann PS, Gerber C (2010) The effect of component positioning on intrinsic stability of the reverse shoulder arthroplasty. J Shoulder Elbow Surg 19(4):550–556CrossRefPubMedGoogle Scholar
  6. 6.
    Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G (2006) Reverse total shoulder arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am 88(8):1742–1747CrossRefPubMedGoogle Scholar
  7. 7.
    Cofield RH, Edgerton BC (1990) Total shoulder arthroplasty: complications and revision surgery. Instr Course Lect 39:449–462PubMedGoogle Scholar
  8. 8.
    Iannotti JP, Norris TR (2003) Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am 85-A(2):251–258CrossRefPubMedGoogle Scholar
  9. 9.
    Boileau P, Watkinson DJ, Hatzidakis AM, Balg F (2005) Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg 14(1 Suppl S):147S–161SCrossRefPubMedGoogle Scholar
  10. 10.
    Scalise JJ, Bryan J, Polster J, Brems JJ, Iannotti JP (2008) Quantitative analysis of glenoid bone loss in osteoarthritis using three-dimensional computed tomography scans. J Shoulder Elbow Surg 17(2):328–335.  https://doi.org/10.1016/j.jse.2007.07.013 CrossRefPubMedGoogle Scholar
  11. 11.
    Scalise JJ, Codsi MJ, Bryan J, Iannotti JP (2008) The three-dimensional glenoid vault model can estimate normal glenoid version in osteoarthritis. J Shoulder Elbow Surg 17(3):487–491.  https://doi.org/10.1016/j.jse.2007.09.006 CrossRefPubMedGoogle Scholar
  12. 12.
    Ohl X, Billuart F, Lagacé PY, Gagey O, Hagemeister N, Skalli W (2012) 3D morphometric analysis of 43 scapulae. Surg Radiol Anat 34(5):447–453.  https://doi.org/10.1007/s00276-012-0933-z CrossRefPubMedGoogle Scholar
  13. 13.
    Codsi MJ, Bennetts C, Gordiev K, Boeck DM, Kwon Y, Brems J, Powell K, Iannotti JP (2008) Normal glenoid vault anatomy and validation of a novel glenoid implant shape. J Shoulder Elbow Surg 17(3):471–478.  https://doi.org/10.1016/j.jse.2007.08.010 CrossRefPubMedGoogle Scholar
  14. 14.
    Friedman RJ, Hawthorne KB, Genez BM (1992) The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 74(7):1032–1037CrossRefPubMedGoogle Scholar
  15. 15.
    Churchill RS, Brems JJ, Kotschi H (2001) Glenoid size, inclination, and version: an anatomic study. J Shoulder Elbow Surg 10(4):327–332CrossRefPubMedGoogle Scholar
  16. 16.
    Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428CrossRefGoogle Scholar
  17. 17.
    Ottenbacher KJ, Tomchek SD (1993) Reliability analysis in therapeutic research: practice and procedures. Am J Occup Ther 47(1):10–16CrossRefPubMedGoogle Scholar
  18. 18.
    Dunn G, Everitt B (1995) Clinical biostatistics: an introduction to evidence based medicine. Edward Arnold, LondonGoogle Scholar
  19. 19.
    Stroud NJ, DiPaola MJ, Martin BL, Steiler CA, Flurin PH, Wright TW et al (2013) Initial glenoid fixation using two different reverse shoulder designs with an equivalent center of rotation in a low-density and high-density bone substitute. J Shoulder Elbow Surg 22(11):1573–1579CrossRefPubMedGoogle Scholar
  20. 20.
    Gilmer BB, Comstock BA, Jette JL, Warme WJ, Jackins SE, Matsen FA (2012) The prognosis for improvement in comfort and function after the ream-and-run arthroplasty for glenohumeral arthritis: an analysis of 176 consecutive cases. J Bone Joint Surg Am 94(14):e102CrossRefPubMedGoogle Scholar
  21. 21.
    Clavert P, Millett PJ, Warner JJ (2007) Glenoid resurfacing: what are the limits to asymmetric reaming for posterior erosion? J Shoulder Elbow Surg 16(6):843–844CrossRefPubMedGoogle Scholar
  22. 22.
    Hsu JE, Ricchetti ET, Huffman GR, Iannotti JP, Glaser DL (2013) Addressing glenoid bone deficiency and asymmetric posterior erosion in shoulder arthroplasty. J Shoulder Elbow Surg 22(9):1298–1308CrossRefPubMedGoogle Scholar
  23. 23.
    Steinmann SP, Cofield RH (2000) Bone grafting for glenoid deficiency in total shoulder replacement. J Shoulder Elbow Surg 9(5):361–367CrossRefPubMedGoogle Scholar
  24. 24.
    Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. J Bone Joint Surg 86(3):388–395CrossRefGoogle Scholar
  25. 25.
    Lévigne C, Boileau P, Favard L, Garaud P, Molé D, Sirveaux F et al (2008) Scapular notching in reverse shoulder arthroplasty. J Shoulder Elbow Surg 17(6):925–935.  https://doi.org/10.1016/j.jse.2008.02.010 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Orthopaedics and Traumatology Unit, Department Emergency and AcceptanceSan Camillo - Forlanini HospitalRomeItaly

Personalised recommendations