Glenoid Inclination: Choosing the Transverse Axis Is Critical-A 3D Automated Versus Manually Measured Study

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Oct 27

PMID 36294372

Authors

Marc-Olivier Gauci

Adrien Jacquot

Francois Boux de Casson

Pierric Deransart

Hoel Letissier

Julien Berhouet

Affiliations

Soon will be listed here.

Abstract

Methods: The glenoid center, trigonum and supraspinatus fossa were identified manually by four expert shoulder surgeons on 82 scapulae CT-scans. The transverse axis was generated either from the identified landmarks (Glenoid-Trigonum line (GT-line), Best-Fit Line Fossa (BFLF)) or by an automatic software (-axis). An assessment of the interobserver reliability was performed. We compared the measured glenoid inclination when modifying the transverse axis to assess its impact.

Results: Glenoid inclination remained stable between 6.3 and 8.5°. The variations occurred significantly when changing the method that determined the transverse axis with a mean biase from -1.7 (BFLF vs. -axis) to 0.6 (BFLF vs. GT-line). The -axis method showed higher stability to the inclination variation ( = 0.030). 9% of cases presented more than 5° of discrepancies between the methods. The manual methods presented a lower ICC (BFLF = 0.96, GT-line = 0.87) with the widest dispersion.

Conclusion: Methods that determine the scapular transverse axis could have a critical impact on the measurement of the glenoid inclination. Despite an overall good concordance, around 10% of cases may provide high discrepancies (≥5°) between the methods with a possible impact on surgeon clinical choice. Trigonum should be used with caution as its anatomy is highly variable and more than two single points provide a better interrater concordance. The -axis is the most stable referential for the glenoid inclination.

Citing Articles

The Role of Arthroscopy in Contemporary Glenoid Fossa Fracture Fixation.

Chalidis B, Papadopoulos P, Papadopoulos P, Pitsilos C Diagnostics (Basel). 2024; 14(9).

PMID: 38732322 PMC: 11083719. DOI: 10.3390/diagnostics14090908.

Can We Completely Trust in Automated Software for Preoperative Planning of Shoulder Arthroplasty? Software Update May Modify Glenoid Version, Glenoid Inclination and Humeral Head Subluxation Values.

Garofalo R, Fontanarosa A, Castagna A, Lassandro N, Del Buono A, De Crescenzo A J Clin Med. 2023; 12(7).

PMID: 37048703 PMC: 10094783. DOI: 10.3390/jcm12072620.

References

Bland J, Altman D . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307-10. View

Beeler S, Hasler A, Gotschi T, Meyer D, Gerber C . Critical shoulder angle: Acromial coverage is more relevant than glenoid inclination. J Orthop Res. 2018; 37(1):205-210. DOI: 10.1002/jor.24053. View

Gauci M, Boileau P, Baba M, Chaoui J, Walch G . Patient-specific glenoid guides provide accuracy and reproducibility in total shoulder arthroplasty. Bone Joint J. 2016; 98-B(8):1080-5. DOI: 10.1302/0301-620X.98B8.37257. View

Boileau P, Cheval D, Gauci M, Holzer N, Chaoui J, Walch G . Automated Three-Dimensional Measurement of Glenoid Version and Inclination in Arthritic Shoulders. J Bone Joint Surg Am. 2018; 100(1):57-65. DOI: 10.2106/JBJS.16.01122. View

Knighton T, Chalmers P, Sulkar H, Aliaj K, Tashjian R, Henninger H . Reverse total shoulder glenoid component inclination affects glenohumeral kinetics during abduction: a cadaveric study. J Shoulder Elbow Surg. 2022; 31(12):2647-2656. PMC: 9669184. DOI: 10.1016/j.jse.2022.06.016. View

Iannotti J, Walker K, Rodriguez E, Patterson T, Jun B, Ricchetti E . Accuracy of 3-Dimensional Planning, Implant Templating, and Patient-Specific Instrumentation in Anatomic Total Shoulder Arthroplasty. J Bone Joint Surg Am. 2019; 101(5):446-457. DOI: 10.2106/JBJS.17.01614. View

Bokor D, OSullivan M, Hazan G . Variability of measurement of glenoid version on computed tomography scan. J Shoulder Elbow Surg. 2000; 8(6):595-8. DOI: 10.1016/s1058-2746(99)90096-4. View

Tashjian R, Martin B, Ricketts C, Henninger H, Granger E, Chalmers P . Superior Baseplate Inclination Is Associated With Instability After Reverse Total Shoulder Arthroplasty. Clin Orthop Relat Res. 2018; 476(8):1622-1629. PMC: 6259729. DOI: 10.1097/CORR.0000000000000340. View

Terrier A, Ston J, Larrea X, Farron A . Measurements of three-dimensional glenoid erosion when planning the prosthetic replacement of osteoarthritic shoulders. Bone Joint J. 2014; 96-B(4):513-8. DOI: 10.1302/0301-620X.96B4.32641. View

10.

Chalmers P, Salazar D, Chamberlain A, Keener J . Radiographic characterization of the B2 glenoid: the effect of computed tomographic axis orientation. J Shoulder Elbow Surg. 2016; 26(2):258-264. DOI: 10.1016/j.jse.2016.07.021. View

11.

De Wilde L, Verstraeten T, Speeckaert W, Karelse A . Reliability of the glenoid plane. J Shoulder Elbow Surg. 2010; 19(3):414-22. DOI: 10.1016/j.jse.2009.10.005. View

12.

Jacquot A, Gauci M, Urvoy M, Boux de Casson F, Berhouet J, Letissier H . Anatomical plane and transverse axis of the scapula: Reliability of manual positioning of the anatomical landmarks. Shoulder Elbow. 2022; 14(5):491-499. PMC: 9527481. DOI: 10.1177/17585732211001756. View

13.

Bercik M, Kruse 2nd K, Yalizis M, Gauci M, Chaoui J, Walch G . A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg. 2016; 25(10):1601-6. DOI: 10.1016/j.jse.2016.03.010. View

14.

Bechtold D, Ganapathy P, Aleem A, Chamberlain A, Keener J . The relationship between glenoid inclination and instability following primary reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2020; 30(7):e370-e377. DOI: 10.1016/j.jse.2020.09.037. View

15.

Gauci M, Deransart P, Chaoui J, Urvoy M, Athwal G, Sanchez-Sotelo J . Three-dimensional geometry of the normal shoulder: a software analysis. J Shoulder Elbow Surg. 2020; 29(12):e468-e477. DOI: 10.1016/j.jse.2020.03.042. View

16.

Patel M, Martin J, Campbell D, Fernandes R, Amini M . Inferior tilt of the glenoid leads to medialization and increases impingement on the scapular neck in reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2020; 30(6):1273-1281. DOI: 10.1016/j.jse.2020.09.023. View

17.

Denard P, Provencher M, Ladermann A, Romeo A, Parsons B, Dines J . Version and inclination obtained with 3-dimensional planning in total shoulder arthroplasty: do different programs produce the same results?. JSES Open Access. 2019; 2(4):200-204. PMC: 6334884. DOI: 10.1016/j.jses.2018.06.003. View

18.

Mahendraraj K, Shields M, Grubhofer F, Golenbock S, Jawa A . Reassessing glenoid inclination in reverse total shoulder arthroplasty with glenosphere lateralization. Bone Joint J. 2021; 103-B(2):360-365. DOI: 10.1302/0301-620X.103B2.BJJ-2020-0843.R1. View

19.

Amini M, Ricchetti E, Iannotti J . Three-Dimensional Templating and Use of Standard Instrumentation in Primary Anatomic Total Shoulder Arthroplasty. JBJS Essent Surg Tech. 2018; 7(3):e28. PMC: 6132710. DOI: 10.2106/JBJS.ST.17.00009. View

20.

Kwon Y, Powell K, Yum J, Brems J, Iannotti J . Use of three-dimensional computed tomography for the analysis of the glenoid anatomy. J Shoulder Elbow Surg. 2005; 14(1):85-90. DOI: 10.1016/j.jse.2004.04.011. View