Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric study
Abstract Background While most anatomic TSA stems allow some intra-operative adjustments, the default configuration assumes that head offset is directly proportional to stem diameter. Some authors reported that humeral head diameter is proportional to intra-medullary canal width and humeral head off...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-09-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40634-018-0148-2 |
| _version_ | 1797335278146289664 |
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| author | Johannes Barth Jérôme Garret Achilleas Boutsiadis Etienne Sautier Laurent Geais Hugo Bothorel Shoulder Friends Institute Arnaud Godenèche |
| author_facet | Johannes Barth Jérôme Garret Achilleas Boutsiadis Etienne Sautier Laurent Geais Hugo Bothorel Shoulder Friends Institute Arnaud Godenèche |
| author_sort | Johannes Barth |
| collection | DOAJ |
| description | Abstract Background While most anatomic TSA stems allow some intra-operative adjustments, the default configuration assumes that head offset is directly proportional to stem diameter. Some authors reported that humeral head diameter is proportional to intra-medullary canal width and humeral head offset, but none investigated the direct relationship between head offset and endosteal measurements. The purpose of the study was to determine whether global humeral head offset is proportional to intramedullary canal width at the distal metaphysis and proximal diaphysis. Methods We analyzed 100 Computed Tomography shoulder scans of patients aged 59.1 ± 20.5 with no signs of gleno-humeral arthritis nor humeral dysplasia. The width of the intramedullary diaphyseal canal was determined at four transverse sections 65, 70, 100 and 105 mm below the head center. The inter-observer agreement was excellent for intramedullary canal width (ICC = 0.96), head diameter (ICC = 0.97) and global head offset (ICC = 0.85). Correlations were analysed using Pearson’s coefficients and multivariable regressions were performed to determine associations between head offset and five independent variables (gender, age, intramedullary canal width, head diameter). Results Global head offset was negatively correlated with head diameter (r = − 0.31, p = 0.002), but not correlated with intramedullary canal width (r = − 0.11, p = 0.282). Multivariable regression confirmed that global head offset was independently associated with head diameter (beta = − 0.15, p = 0.005), but not with intramedullary canal width (beta = 0.06, p = 0.431). Conclusions The present study revealed that humeral offset is not correlated with intramedullary canal width. Implant manufacturers and shoulder surgeons should be aware of the subtle morphologic features, to enhance humeral stem design and restore native anatomy. |
| first_indexed | 2024-03-08T08:34:38Z |
| format | Article |
| id | doaj.art-c1263461463a4f16a3e174dd7aa10cce |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T08:34:38Z |
| publishDate | 2018-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-c1263461463a4f16a3e174dd7aa10cce2024-02-02T02:05:49ZengSpringerOpenJournal of Experimental Orthopaedics2197-11532018-09-01511810.1186/s40634-018-0148-2Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric studyJohannes Barth0Jérôme Garret1Achilleas Boutsiadis2Etienne Sautier3Laurent Geais4Hugo Bothorel5Shoulder Friends Institute6Arnaud Godenèche7Department of Orthopaedic Surgery, Centre Osteoarticulaire des CèdresClinique du ParcDepartment of Orthopaedic Surgery, Centre Osteoarticulaire des CèdresOrthopaedic Surgery, University Hospital of Saint EtienneMove-Up SASReSurg SAShoulder Friends InstituteRamsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique SantyAbstract Background While most anatomic TSA stems allow some intra-operative adjustments, the default configuration assumes that head offset is directly proportional to stem diameter. Some authors reported that humeral head diameter is proportional to intra-medullary canal width and humeral head offset, but none investigated the direct relationship between head offset and endosteal measurements. The purpose of the study was to determine whether global humeral head offset is proportional to intramedullary canal width at the distal metaphysis and proximal diaphysis. Methods We analyzed 100 Computed Tomography shoulder scans of patients aged 59.1 ± 20.5 with no signs of gleno-humeral arthritis nor humeral dysplasia. The width of the intramedullary diaphyseal canal was determined at four transverse sections 65, 70, 100 and 105 mm below the head center. The inter-observer agreement was excellent for intramedullary canal width (ICC = 0.96), head diameter (ICC = 0.97) and global head offset (ICC = 0.85). Correlations were analysed using Pearson’s coefficients and multivariable regressions were performed to determine associations between head offset and five independent variables (gender, age, intramedullary canal width, head diameter). Results Global head offset was negatively correlated with head diameter (r = − 0.31, p = 0.002), but not correlated with intramedullary canal width (r = − 0.11, p = 0.282). Multivariable regression confirmed that global head offset was independently associated with head diameter (beta = − 0.15, p = 0.005), but not with intramedullary canal width (beta = 0.06, p = 0.431). Conclusions The present study revealed that humeral offset is not correlated with intramedullary canal width. Implant manufacturers and shoulder surgeons should be aware of the subtle morphologic features, to enhance humeral stem design and restore native anatomy.http://link.springer.com/article/10.1186/s40634-018-0148-2Intramedullary canal widthHumeral offsetCorrelationAssociationProximal humerusImplant design |
| spellingShingle | Johannes Barth Jérôme Garret Achilleas Boutsiadis Etienne Sautier Laurent Geais Hugo Bothorel Shoulder Friends Institute Arnaud Godenèche Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric study Journal of Experimental Orthopaedics Intramedullary canal width Humeral offset Correlation Association Proximal humerus Implant design |
| title | Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric study |
| title_full | Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric study |
| title_fullStr | Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric study |
| title_full_unstemmed | Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric study |
| title_short | Is global humeral head offset related to intramedullary canal width? A computer tomography morphometric study |
| title_sort | is global humeral head offset related to intramedullary canal width a computer tomography morphometric study |
| topic | Intramedullary canal width Humeral offset Correlation Association Proximal humerus Implant design |
| url | http://link.springer.com/article/10.1186/s40634-018-0148-2 |
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