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Is there a relationship between Buford complex and glenoid version?

Haluk Yaka1, Mustafa Özer1, Hasan Rüzgar1

  • 1Necmettin Erbakan University School of Medicine, Department of Orthopaedics & Traumatology, Konya, Turkey.

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
|May 30, 2025
PubMed
Summary
This summary is machine-generated.

The Buford complex (BC) is associated with a more anteverted (forward-tilted) glenoid in patients with rotator cuff tears (RCT) and anterior shoulder instability (ASI). This finding suggests BC may be a compensatory variation influencing shoulder morphology.

Keywords:
Buford complexGlenoid versionLabral variationsMGHLScapula morphology

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Area of Science:

  • Orthopedic Surgery
  • Shoulder Arthroscopy
  • Radiology

Background:

  • The Buford complex (BC) is an anatomical variation found during shoulder arthroscopy.
  • Its relationship with scapular morphology in patients with anterior shoulder instability (ASI) and rotator cuff tears (RCT) is not well understood.
  • This study investigates the association between BC and scapular parameters.

Purpose of the Study:

  • To determine the relationship between the arthroscopically identified Buford complex (BC) and scapular morphology.
  • To compare glenoid version (GV), glenoid inclination (GI), and critical shoulder angle (CSA) in patients with and without BC.
  • To explore the potential role of BC as a compensatory mechanism in shoulder pathologies.

Main Methods:

  • Retrospective analysis of 1947 shoulder arthroscopy cases (2015-2023).
  • Inclusion of groups: BC with ASI, RCT with BC, RCT control, ASI control, and general control.
  • Comparison of GV and GI from MRI, and CSA from radiographs across all groups.

Main Results:

  • Patients with BC (in both RCT and ASI groups) showed significantly lower mean glenoid version (GV) compared to control groups.
  • Mean GV was significantly lower in the RCT with BC group (-1º±3.3º) versus RCT control (7.7º± 5.7º).
  • Mean GV was significantly lower in the ASI with BC group (-1.9º± 3.6º) versus ASI control (3.35º± 4.8º).
  • No significant differences were found in glenoid inclination (GI) or critical shoulder angle (CSA) between groups.

Conclusions:

  • A more anteverted glenoid (reduced GV) is associated with the presence of the Buford complex in patients with RCT and ASI.
  • The BC may represent a compensatory adaptation to anterior humeral head translation caused by reduced GV.
  • Clinicians should consider the possibility of an anteverted glenoid when diagnosing BC.