Glenoid morphology in reverse shoulder arthroplasty: classification and surgical implications.
BACKGROUND
A great challenge in reverse shoulder arthroplasty is the wide variation in glenoid morphology that adds uncertainties in glenoid component placement. The purpose of this study was to classify glenoid morphology and examining its effect on possible glenoid component fixation.


METHODS
The morphology of 216 glenoids was classified into normal and abnormal with subgroups defined by erosion sites. Six anatomic and 2 surgical parameters were compared among the classified groups. Plain radiographs or 2-dimensional (2D) computed tomography (CT) scans showed 62.5% of glenoids were normal and 37.5% were abnormal, with further subclassification of abnormal in posterior (17.6%), superior (9.3%), global (6.5%), and anterior (4.2%) erosions using 3D CT models.


RESULTS
The standard centerline became significantly shorter in abnormal (19.6 +/- 9.1 mm) than in normal (28.6 +/- 4.1 mm, P < .0001) glenoids. Alternatively, the spine centerline provided longer bony distance in abnormal glenoids (34.9 +/- 17.0 mm). Abnormal glenoid morphology also reduced peripheral screw placement area by 42% and limited it to the anterior and inferior quadrants.


CONCLUSIONS
Glenoid morphology of the rotator cuff deficient shoulder can be reliably classified using this classification system consisting of normal and abnormal, which included 4 subgroups of posterior, superior, global, and anterior erosions.


CONCLUSIONS
Abnormal glenoid morphology was shown to have a significant effect on anatomical and surgical factors which can necessitate adjustments in surgical technique for reverse shoulder arthroplasty.


METHODS
Basic Science Study.
Frankle
Mark A
MA
Florida Orthopaedic Institute, Tampa, FL 33637, USA. frankle@pol.net
Teramoto
Atsushi
A
Luo
Zong-Ping
ZP
Levy
Jonathan C
JC
Pupello
Derek
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012540:Scapula / Q000033:anatomy & histology*; D012785:Shoulder Joint / Q000033:anatomy & histology* / Q000601:surgery*