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Biconcave glenoids show 3 differently oriented posterior erosion patterns.

Alexander Otto1, Bastian Scheiderer2, Matthew Murphy3

  • 1Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, Farmington, CT, USA; Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany; Department of Trauma, Orthopaedic, Plastic and Hand Surgery, University Hospital of Augsburg, Augsburg, Germany.

Journal of Shoulder and Elbow Surgery
|May 8, 2021
PubMed
Summary
This summary is machine-generated.

Posterior glenoid wear in reverse total shoulder arthroplasty (rTSA) presents distinct patterns: posterior-superior, posterior-central, and posterior-inferior. Acromial orientation did not significantly correlate with these erosion patterns.

Keywords:
Posterior glenoid erosionbiconcave glenoidglenoid bone lossshoulder arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Radiology

Background:

  • Posterior glenoid wear is a significant challenge in anatomic and reverse total shoulder arthroplasty (rTSA).
  • Asymmetric erosion and altered retroversion characterize this wear, impacting surgical outcomes.
  • Understanding glenoid morphology and its relationship with acromial orientation is crucial for improving rTSA procedures.

Purpose of the Study:

  • To assess glenoid morphology in patients undergoing rTSA.
  • To evaluate the influence of acromial orientation on posterior glenoid erosion patterns.
  • To classify distinct posterior glenoid wear patterns using 3D models.

Main Methods:

  • Computed tomographic (CT) scans of 68 patients awaiting rTSA were converted into 3D models.
  • Morphology, erosion depth and orientation, inclination, retroversion, and acromial orientation were analyzed.
  • Measurements were compared across different wear patterns and genders.

Main Results:

  • Three distinct posterior glenoid wear patterns were identified: posterior-central (PC), posterior-inferior (PI), and posterior-superior (PS).
  • These patterns significantly differed in erosion orientation (PC: 86.9°, PI: 116.3°, PS: 62.3°).
  • Posterior-central wear showed the greatest erosion depth (7.3 mm). No significant differences were found based on gender or acromial orientation.

Conclusions:

  • Three distinct, significantly different posterior glenoid wear patterns (PS, PC, PI) were identified.
  • These patterns are distinguishable on axillary imaging.
  • Acromial orientation did not show significant correlations with the observed posterior erosion patterns.