The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty
Abstract Background The success of shoulder arthroplasty, both reverse and anatomical, depends on correcting the underlying glenoid deformity especially in patients with an osteoarthritis. We hypothesized that the distribution of glenoid version and especially inclination are underestimated in the s...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03690-8 |
| _version_ | 1818442096396206080 |
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| author | Omer Ozel Robert Hudek Mohamed S. Abdrabou Birgit S. Werner Frank Gohlke |
| author_facet | Omer Ozel Robert Hudek Mohamed S. Abdrabou Birgit S. Werner Frank Gohlke |
| author_sort | Omer Ozel |
| collection | DOAJ |
| description | Abstract Background The success of shoulder arthroplasty, both reverse and anatomical, depends on correcting the underlying glenoid deformity especially in patients with an osteoarthritis. We hypothesized that the distribution of glenoid version and especially inclination are underestimated in the shoulder arthritis population, and also that superior glenoid inclination can be detected through 3-dimensional (3D) software program of computed tomography (CT) to a greater proportion in patients with rotator cuff insufficiency, but also in patients with osteoarthritis with an intact rotator cuff. Because of the influence of rotator cuff imbalance on secondary glenoid wear the values of the critical shoulder angle (CSA) and the fatty infiltration of the rotator cuff are further analyzed. The aim of our study is to determine; 1) the distribution of glenoid inclination and version; 2) the relationship between glenoid inclination, version, the critical shoulder angle (CSA) to the status of the rotator cuff; 3) the proportion of patients with both an intact rotator cuff and a superior inclination greater than 10°. Methods A total of 231 shoulders were evaluated with X-ray images, 3-dimentional (3D) software program of computed tomography (CT), and magnetic resonance imaging. The cohort was divided into 3 groups according to their inclination angles and also grouped as intact-rotator cuff and torn-cuff group. Results The median (min/max) values for the 231 shoulders were 8° (− 23°/56°) for the inclination angle, − 11°(− 55°/23°) for the version angle, and 31.5°(17.6°/61.6°) for the CSA. The majority of the glenoids were found to show posterior-superior erosion. Glenoid inclination angle and CSA were significantly higher in torn-cuff group when compared with intact-cuff group (P < 0.001, both). The rotator cuff tears were statistically significant in high inclination group than low inclination group and no inclination group (p < 0.001). In the high inclination group, 41 of 105 (39%) shoulders had an intact rotator cuff, in about 18% of all shoulders. Conclusion Our findings show that 3D evaluation of glenoid inclination is mandatory for preoperative planning of shoulder replacement in order to properly assess superior inclination and that reverse shoulder arthroplasty may be considered more frequently than as previously expected, even when the rotator cuff is intact. Level of evidence Level III. |
| first_indexed | 2024-12-14T18:38:43Z |
| format | Article |
| id | doaj.art-8d21aa3674e64824b8db8ecf32a0c98e |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-14T18:38:43Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-8d21aa3674e64824b8db8ecf32a0c98e2022-12-21T22:51:33ZengBMCBMC Musculoskeletal Disorders1471-24742020-10-012111810.1186/s12891-020-03690-8The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplastyOmer Ozel0Robert Hudek1Mohamed S. Abdrabou2Birgit S. Werner3Frank Gohlke4Department of Orthopaedics, Baskent University Istanbul HospitalDepartment of Shoulder Surgery, Rhön KlinikumDepartment of Shoulder Surgery, Rhön KlinikumDepartment of Shoulder Surgery, Rhön KlinikumDepartment of Shoulder Surgery, Rhön KlinikumAbstract Background The success of shoulder arthroplasty, both reverse and anatomical, depends on correcting the underlying glenoid deformity especially in patients with an osteoarthritis. We hypothesized that the distribution of glenoid version and especially inclination are underestimated in the shoulder arthritis population, and also that superior glenoid inclination can be detected through 3-dimensional (3D) software program of computed tomography (CT) to a greater proportion in patients with rotator cuff insufficiency, but also in patients with osteoarthritis with an intact rotator cuff. Because of the influence of rotator cuff imbalance on secondary glenoid wear the values of the critical shoulder angle (CSA) and the fatty infiltration of the rotator cuff are further analyzed. The aim of our study is to determine; 1) the distribution of glenoid inclination and version; 2) the relationship between glenoid inclination, version, the critical shoulder angle (CSA) to the status of the rotator cuff; 3) the proportion of patients with both an intact rotator cuff and a superior inclination greater than 10°. Methods A total of 231 shoulders were evaluated with X-ray images, 3-dimentional (3D) software program of computed tomography (CT), and magnetic resonance imaging. The cohort was divided into 3 groups according to their inclination angles and also grouped as intact-rotator cuff and torn-cuff group. Results The median (min/max) values for the 231 shoulders were 8° (− 23°/56°) for the inclination angle, − 11°(− 55°/23°) for the version angle, and 31.5°(17.6°/61.6°) for the CSA. The majority of the glenoids were found to show posterior-superior erosion. Glenoid inclination angle and CSA were significantly higher in torn-cuff group when compared with intact-cuff group (P < 0.001, both). The rotator cuff tears were statistically significant in high inclination group than low inclination group and no inclination group (p < 0.001). In the high inclination group, 41 of 105 (39%) shoulders had an intact rotator cuff, in about 18% of all shoulders. Conclusion Our findings show that 3D evaluation of glenoid inclination is mandatory for preoperative planning of shoulder replacement in order to properly assess superior inclination and that reverse shoulder arthroplasty may be considered more frequently than as previously expected, even when the rotator cuff is intact. Level of evidence Level III.http://link.springer.com/article/10.1186/s12891-020-03690-8Shoulder arthritisRotator cuffGlenoid version anglesGlenoid inclination angles3D measurementsPreoperative planning |
| spellingShingle | Omer Ozel Robert Hudek Mohamed S. Abdrabou Birgit S. Werner Frank Gohlke The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty BMC Musculoskeletal Disorders Shoulder arthritis Rotator cuff Glenoid version angles Glenoid inclination angles 3D measurements Preoperative planning |
| title | The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty |
| title_full | The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty |
| title_fullStr | The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty |
| title_full_unstemmed | The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty |
| title_short | The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty |
| title_sort | implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty |
| topic | Shoulder arthritis Rotator cuff Glenoid version angles Glenoid inclination angles 3D measurements Preoperative planning |
| url | http://link.springer.com/article/10.1186/s12891-020-03690-8 |
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