Dr Michell Ruiz

Dr Michell Ruiz
Cirugía de hombro y del Manguito rotador

martes, 8 de octubre de 2013

Three-dimensional assessment of the dimensions of the osteoarthritic glenoid

http://www.bjj.boneandjoint.org.uk/content/95-B/10/1377.abstract

Three-dimensional assessment of the dimensions of the osteoarthritic glenoid

  1. A. Young, MSpMed, PhD, FRACS, Orthopaedic Surgeon7 Author Profile
+Author Affiliations
  1. 1Centre Orthopédique Santy- Hopital Privé Jean MERMOZ, Department of Orthopaedic Surgery, 24 Avenue Paul Santy, Lyon 69008, France.
  2. 2Massachusetts General Hospital, 55 Fruit Street, Yawkey 3G Boston, Massachusetts 02114, USA.
  3. 3L’Archet 2 Hospital, Department of Orthopaedic Surgery and Sports Traumatology, 151 rte de St A. de Ginestière, 06200 Nice, France.
  4. 4Fondren Orthopedic Group LLP, 7401 South Main, Houston, Texas 77030, USA.
  5. 5Clinique du Parc, 155 Boulevard Stalingrad, 69006 Lyon, France.
  6. 6Centre Orthopédique Pasteur Lanroze, 18 rue Amiral Romain Desfossés, 29200 Brest, France.
  7. 7Sydney Shoulder Specialists, Level 2, 156 Pacific Highway, St Leonards 2065, New South Wales, Australia.
  1. Correspondence should be sent to Dr G. Walch; e-mail:walch.gilles@wanadoo.fr

Abstract

Osteoarthritis results in changes in the dimensions of the glenoid. This study aimed to assess the size and radius of curvature of arthritic glenoids. A total of 145 CT scans were analysed, performed as part of routine pre-operative assessment before total shoulder replacement in 91 women and 54 men. Only patients with primary osteoarthritis and a concentric glenoid were included in the study. The CT scans underwent three-dimensional (3D) reconstruction and were analysed using dedicated computer software. The measurements consisted of maximum superoinferior height, anteroposterior width and a best-fit sphere radius of curvature of the glenoid.
The mean height was 40.2 mm (SD 4.9), the mean width was 29 mm (SD 4.3) and the mean radius of curvature was 35.4 mm (SD 7.8). The measurements were statistically different in men and women and had a Gaussian distribution with marked variation. All measurements were greater than the known values in normal subjects.
With current shoulder replacement systems using a unique backside radius of curvature for the glenoid component, there is a risk of undertaking excessive reaming to adapt the bone to the component resulting in sacrifice of subchondral bone or under-reaming and instability of the component due to a ’rocking horse‘ phenomenon.
Cite this article: Bone Joint J 2013;95-B:1377–82.

Footnotes

  • The authors wish to thank P. Deransart, L. Ferrand, A. Amblard and J. Chaoui for their technical assistance.
    Tornier, Inc. (Bloomington, Minnesota, United States) funded this study through Imascap (Brest, France) for the development of the software and the measurements of the arthritic glenoids.
    The author or one or more of the authors have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article.
    This article was primary edited by P. Baird and first-proof edited by J. Scott.
  • Received March 15, 2013.
  • Accepted June 5, 2013.

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