Quantitative assessment and characterization of glenoid bone loss in a spectrum of patients with glenohumeral osteoarthritis.
OBJECTIVE
Eccentric posterior bone loss and associated glenoid retroversion represent challenges to glenoid placement during total shoulder arthroplasty. This bone loss can lead to poor stability and perforation of the glenoid during arthroplasty. The purpose of this study was to evaluate the morphology of glenoid bone loss for a spectrum of osteoarthritis patients using 3D computed tomography imaging and simulation software.


METHODS
This study included 29 patients with glenohumeral osteoarthritis treated with shoulder arthroplasty. Three-dimensional reconstruction of preoperative CT images was performed. Glenoid bone loss was measured at ten, vertically equidistant axial planes along the glenoid surface at four distinct anterior-posterior points on each plane. The images were fitted with modeled pegged glenoid implants to predict glenoid perforation.


RESULTS
The 3D maps demonstrated greatest average bone loss posteriorly in the AP plane at the central axis of the glenoid in the SI plane. The average amount of bone loss was 3.85 mm. Walch A2 and B1 shoulders showed more central bone loss, while Walch B2 shoulders displayed more posterior and inferior bone loss. Patients with predicted peg perforation displayed significantly greater bone loss than those without predicted peg perforation (p = 0.037). Peg perforation was most common in Walch B2 shoulders occurring in the posterior direction involving the central and posterior-inferior peg.


CONCLUSIONS
These data demonstrate an anatomic pattern of glenoid bone loss for different classes of glenohumeral arthritis. These findings can be used to develop various models of glenoid bone loss to guide surgeons, predict failures, and develop better glenoid implants. This study has been approved by the Cleveland Clinic IRB: Number 6235.
Department of Orthopaedic Surgery, Wayne State University School of Medicine, 10000 Telegraph Road, Taylor, MI, USA.
D J
DJ
Lombardo
Department of Orthopaedic Surgery, Wayne State University School of Medicine, 10000 Telegraph Road, Taylor, MI, USA.
J
J
Khan
Kalamazoo College, Kalamazoo, MI, USA.
B
B
Prey
Department of Biomedical Engineering, Wayne State University School of Engineering, Detroit, MI, USA.
L
L
Zhang
Department of Orthopaedic Surgery, Wayne State University School of Medicine, 10000 Telegraph Road, Taylor, MI, USA.
G R
GR
Petersen-Fitts
Department of Orthopaedic Surgery, Wayne State University School of Medicine, 10000 Telegraph Road, Taylor, MI, USA. sabes001@gmail.com.
V J
VJ
Sabesan
D019643:Arthroplasty, Replacement / Q000295:instrumentation / Q000379:methods; D003198:Computer Simulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D010003:Osteoarthritis / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D018570:Risk Assessment; D012540:Scapula / Q000000981:diagnostic imaging; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
3D imaging; Glenoid bone loss; Osteoarthritis; Shoulder arthroplasty