The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study
Background: Cuff tear arthropathy (CTA) is characterized by superior migration of the humeral head with superior erosion of the glenoid. Rarely, humeral head migration can be anteroinferior with associated anterior erosion of the glenoid, a pattern described by Favard as the type E4 glenoid. The pur...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/11/3704 |
| _version_ | 1797547524993581056 |
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| author | Gilles Walch Philippe Collotte Patric Raiss George S. Athwal Marc Olivier Gauci |
| author_facet | Gilles Walch Philippe Collotte Patric Raiss George S. Athwal Marc Olivier Gauci |
| author_sort | Gilles Walch |
| collection | DOAJ |
| description | Background: Cuff tear arthropathy (CTA) is characterized by superior migration of the humeral head with superior erosion of the glenoid. Rarely, humeral head migration can be anteroinferior with associated anterior erosion of the glenoid, a pattern described by Favard as the type E4 glenoid. The purpose of this retrospective imaging study was to analyze the 2D and 3D characteristics of the E4 glenoid. Methods: A shoulder arthroplasty database of 258 cuff tear arthropathies was examined to identify patients with an E4 type deformity. This resulted in a study cohort of 15 females and 2 males with an average age of 75 years. All patients had radiographs and CT scans available for analysis. CT-scan DICOM (Digital Imaging and Communications in Medicine) data were uploaded to a validated three-dimensional (3D) imaging software. Muscle fatty infiltration, glenoid measurements (anteversion, inclination), and humeral head subluxation according to the scapular plane were determined. Results: The mean anteversion and inclination of the E4 cohort were 32° ± 14° and −5° ± 2, respectively. The mean anterior subluxation was 19% ± 16%. All cases had severe grade 3 or 4 fatty infiltration of the infraspinatus, whereas only 65% had grade 3 or 4 subscapularis fatty infiltration. A significant correlation existed between glenoid anteversion and humeral head subluxation (<i>p</i> < 0.001), but no correlation was found with muscle fatty infiltration. The CT analysis demonstrated an acquired erosive biconcave morphology in 11 patients (65%) and monoconcavity in 6 patients (35%). Conclusion: The E4 type glenoid deformity in cuff tear arthropathy is characterized by an anterior erosion and anteversion associated with anterior subluxation of the humeral head. |
| first_indexed | 2024-03-10T14:45:17Z |
| format | Article |
| id | doaj.art-deb39f55db0e4c638d5bafad9fabb084 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T14:45:17Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-deb39f55db0e4c638d5bafad9fabb0842023-11-20T21:27:39ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-01911370410.3390/jcm9113704The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT StudyGilles Walch0Philippe Collotte1Patric Raiss2George S. Athwal3Marc Olivier Gauci4Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Générale de Santé, 69008 Lyon, FranceCentre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Générale de Santé, 69008 Lyon, FranceOCM Clinic, Steinerstrasse 6, 81369 Munich, GermanyRoth/McFarlane Hand and Upper Limb Center, St Joseph’s Health Care, Western University, London, ON N6G 4E7, CanadaInstitut Universitaire Locomoteur & Sport, Unité de Recherche Clinique Côte d’Azur (UR2CA), Hôpital Pasteur 2, Université Côte d’Azur, 06000 Nice, FranceBackground: Cuff tear arthropathy (CTA) is characterized by superior migration of the humeral head with superior erosion of the glenoid. Rarely, humeral head migration can be anteroinferior with associated anterior erosion of the glenoid, a pattern described by Favard as the type E4 glenoid. The purpose of this retrospective imaging study was to analyze the 2D and 3D characteristics of the E4 glenoid. Methods: A shoulder arthroplasty database of 258 cuff tear arthropathies was examined to identify patients with an E4 type deformity. This resulted in a study cohort of 15 females and 2 males with an average age of 75 years. All patients had radiographs and CT scans available for analysis. CT-scan DICOM (Digital Imaging and Communications in Medicine) data were uploaded to a validated three-dimensional (3D) imaging software. Muscle fatty infiltration, glenoid measurements (anteversion, inclination), and humeral head subluxation according to the scapular plane were determined. Results: The mean anteversion and inclination of the E4 cohort were 32° ± 14° and −5° ± 2, respectively. The mean anterior subluxation was 19% ± 16%. All cases had severe grade 3 or 4 fatty infiltration of the infraspinatus, whereas only 65% had grade 3 or 4 subscapularis fatty infiltration. A significant correlation existed between glenoid anteversion and humeral head subluxation (<i>p</i> < 0.001), but no correlation was found with muscle fatty infiltration. The CT analysis demonstrated an acquired erosive biconcave morphology in 11 patients (65%) and monoconcavity in 6 patients (35%). Conclusion: The E4 type glenoid deformity in cuff tear arthropathy is characterized by an anterior erosion and anteversion associated with anterior subluxation of the humeral head.https://www.mdpi.com/2077-0383/9/11/3704shouldercuff tear arthropathyglenoid anteversionhumeral head subluxationFavard E4reverse shoulder arthroplasty |
| spellingShingle | Gilles Walch Philippe Collotte Patric Raiss George S. Athwal Marc Olivier Gauci The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study Journal of Clinical Medicine shoulder cuff tear arthropathy glenoid anteversion humeral head subluxation Favard E4 reverse shoulder arthroplasty |
| title | The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study |
| title_full | The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study |
| title_fullStr | The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study |
| title_full_unstemmed | The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study |
| title_short | The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study |
| title_sort | characteristics of the favard e4 glenoid morphology in cuff tear arthropathy a ct study |
| topic | shoulder cuff tear arthropathy glenoid anteversion humeral head subluxation Favard E4 reverse shoulder arthroplasty |
| url | https://www.mdpi.com/2077-0383/9/11/3704 |
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