title: A glenoid reaming study: how accurate are current reaming techniques?
abstract: BACKGROUND
  Correct reaming of a degenerative glenoid can be a difficult procedure. We investigated how the quality of the reamed surface is influenced by different reamers, by the surgeon's experience, and by glenoid erosion patterns.
  
  
  METHODS
  Three shoulder surgeons performed reaming procedures with different types of reamers (flat, convex, K-wire guided, and nipple guided) on a series of similarly sized uniconcave and biconcave glenoids. The reproducibility of reaming and the effect of different reamers on different-shaped glenoids were measured and evaluated.
  
  
  RESULTS
  The center and direction of reaming were constant for all surgeons in the case of type A glenoids. For type B2 glenoids, the center and direction of reaming differed significantly between surgeons. The congruity of the reamed surface was better after flat reaming than after convex reaming. Whether the reamers were guided by a central K-wire or by a nipple had no significant effect on the reamed surface. The experience of the surgeon had no effect on the congruity of reaming.
  
  
  CONCLUSIONS
  Reaming of a uniconcave glenoid is reproducible, but reaming of a biconcave glenoid seems much more difficult. Erosion and deformity of the glenoid influence the accuracy of reaming the most. Surgical experience plays a less important role. We conclude that there is a need for guidance in reaming of biconcave glenoids.
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium. Electronic address: anne.karelse@telenet.be.
authors.forename: Anne
authors.initials: A
authors.lastname: Karelse
authors.affiliation: Department of Mechanical Engineering, Biomechanics Section, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Leuridan
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Alexander
authors.initials: A
authors.lastname: Van Tongel
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Iwein M
authors.initials: IM
authors.lastname: Piepers
authors.affiliation: Department of Development and Regeneration, Division of Orthopedics, University Hospital Pellenberg, Pellenberg, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Debeer
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Lieven F
authors.initials: LF
authors.lastname: De Wilde
mesh_terms: D019643:Arthroplasty, Replacement / Q000295:instrumentation / Q000379:methods*; D003198:Computer Simulation; D006801:Humans; D008953:Models, Anatomic; D015203:Reproducibility of Results; D012540:Scapula / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery
keywords: Glenoid; erosion; prosthesis; reaming; shoulder; version