title: Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors.
abstract: Placement of the glenoid baseplate is of paramount importance for the outcome of anatomical and reverse total shoulder arthroplasty. However, the database around glenoid size is poor, particularly regarding small scapulae, for example, in women and smaller individuals, and is derived from different methodological approaches. In this multimodality cadaver study, we systematically examined the glenoid using morphological and 3D-CT measurements.
  
  
  
  Measurements of the glenoid and drill hole tunnel length for superior baseplate screw placement were recorded to define size of the glenoid and the distance to the scapular notch on cadaveric specimens. Glenoid angles were determined on both, 3D-CT-scans of the thoraxes using the Friedman method and on subsequently isolated scapulae from 18 male and female donors (average 84 years, range 60-98 years).
  
  
  
  Mean glenoid height was 36.6 mm ± 3.6, and width 27.8 mm ± 3.1 with a significant sex dimorphism (p ≤ 0.001): in males, glenoid height 39.5 mm ± 3.5, and width 30.3 mm ± 3.3, and in females, glenoid height 34.8 mm ± 2.2, and width 26.2 mm ± 1.6. The average distance from the superior screw entry to its exit in the scapular notch measured by calliper was 27.2 mm ± 6.0 with a sex difference: in males, 29.4 mm ± 5.7, and in females, 25.8 mm ± 5.9 mm with a minimum recorded distance of 15 mm. Measured by CT, the mean inclination angle for male and female donors combined was 13.0° ± 7.0, and the ante-/retroversion angle -1.0° ± 4.0°.
  
  
  
  This study is one of the first to combine dissection, including drill holes, with anatomical measurements and radiological data. In some women and smaller individuals, smaller baseplates should be selected. The published safe zone of 20 mm is generally feasible for superior screw placement, however, in small patients this distance may be substantially shorter than expected and start as of 13 and 15 mm, respectively. No correlation between glenoid height or width with the length of our drilling canal towards the scapular notch was found. Preoperative CT-based treatment planning to determine version and inclination angles is recommended.
authors.affiliation: Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland. sandra.mathews@iem.uzh.ch.
authors.forename: Sandra
authors.identifier: 0000-0002-7399-6422
authors.initials: S
authors.lastname: Mathews
authors.affiliation: Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Burkhard
authors.affiliation: Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland.|Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.
authors.forename: Nabil
authors.initials: N
authors.lastname: Serrano
authors.affiliation: Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland.|Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.
authors.forename: Karl
authors.initials: K
authors.lastname: Link
authors.affiliation: Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland.|Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Häusler
authors.affiliation: Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland.
authors.forename: Nakita
authors.initials: N
authors.lastname: Frater
authors.affiliation: Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Franke
authors.affiliation: Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.
authors.forename: Helena
authors.initials: H
authors.lastname: Bischofberger
authors.affiliation: Medical Radiology Institute, Schulthess Clinic, Zurich, Switzerland.|Medical Faculty, University of Zurich, Zurich, Switzerland.
authors.forename: Florian M
authors.initials: FM
authors.lastname: Buck
authors.affiliation: Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Dominic
authors.initials: D
authors.lastname: Gascho
authors.affiliation: Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Thali
authors.affiliation: Institute of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Serowy
authors.affiliation: Musculoskeletal Research Unit, Department of Biomedicine, University of Basel, Basel, Switzerland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Müller-Gerbl
authors.affiliation: Shoulder Unit, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: Gareth
authors.initials: G
authors.lastname: Harper
authors.affiliation: Shoulder Unit, Doncaster Royal Infirmary, Doncaster, UK.
authors.forename: Ford
authors.initials: F
authors.lastname: Qureshi
authors.affiliation: Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland.|Technical Orthopedics Unit, University Hospital Balgrist, Zurich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Böni
authors.affiliation: Shoulder Surgery Unit, Ospedale Civico, Lugano, Switzerland.
authors.forename: Hans-Rudolf
authors.initials: HR
authors.lastname: Bloch
authors.affiliation: Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Ullrich
authors.affiliation: Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland.
authors.forename: Frank-Jakobus
authors.initials: FJ
authors.lastname: Rühli
authors.affiliation: Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.|Institute of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany.|Musculoskeletal Research Unit, Department of Biomedicine, University of Basel, Basel, Switzerland.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Eppler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D002102:Cadaver; D004210:Dissection / Q000379:methods*; D005260:Female; D061165:Glenoid Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012785:Shoulder Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Anatomical and reverse total shoulder arthroplasty; Anteversion angle; Dissection study; Glenoid cavity; Inclination angle; Retroversion angle; Screw placement; Suprascapular nerve