Version reckoning of variant glenoid levels: a radiological study on dry human scapulae
Keywords:Glenoid, Version, CT scan, Coracoid tip-inferior glenoid tubercle distance
Background: Preoperative glenoid version measurement can guide base plate implantation and directing screws positioning. Glenoid vault depth affects guide-wire insertion with accurate inclinations towards maximum bone stock. No consensus exists regards the precise glenoid level for version assessment, whether at midaxial or coracoid tip level, and if those values are identical or not. Additionally, there is not much data in literature concerning the deepest point of glenoid vault and its proximity to anterior and inferior glenoid surfaces. Thus, we aimed in this study to report glenoid version values at all levels utilizing two different methodologies (Freidman method, vault version method). Additionally, detecting deepest vault point and how much distant from anterior and inferior glenoid aspects.
Methods: Sixty dry, unpaired scapulae were scanned with 1.25mm-thick slices. Version was measured at all levels and compared. Axial and coronal slices with greatest vault depth was determined and distance from anterior and inferior glenoid rims were determined.
Results: Version method showed significant difference in version at coracoid tip and midaxial levels (p<0.001). Mean versions were 18.2±10.6º and 8.9±6.8º respectively. Also, significant difference was noted between version of upper, middle, and lower thirds, except between middle and lower thirds. A significant difference was evident between both methodologies on comparing version at coracoid tip level (p<0.001).
Conclusions: Glenoid version at coracoid tip and midaxial levels are not the same. Correlation of preoperative version values with intraoperative situations might be studied in future studies.
Gregory TM, Sankey A, Augereau B, Vandenbussche E, Amis A, Emery R, et al. Accuracy of glenoid component placement in total shoulder arthroplasty and its effect on clinical and radiological outcome in a retrospective, longitudinal, monocentric open study. PLoS One. 2013;8(10):e75791.
Wang AW, Hayes A, Gibbons R, Mackie KE. Computer navigation of the glenoid component in reverse total shoulder arthroplasty: a clinical trial to evaluate the learning curve. J Shoulder Elbow Surg. 2020;29(3):617-23.
von Schroeder HP, Kuiper SD, Botte MJ. Osseous anatomy of the scapula. Clin Orthop Relat Res. 2001;383:131-9.
Churchill RS, Brems JJ, Kotschi H. Glenoid size, inclination, and version: an anatomic study. J Shoulder Elbow Surg. 2001;10(4):327-32.
Iannotti JP, Greeson C, Downing D, Sabesan V, Bryan JA. Effect of glenoid deformity on glenoid component placement in primary shoulder arthroplasty. J Shoulder Elbow Surg. 2012;21(1):48-55.
Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am. 1992;74(7):1032-7.
Rouleau DM, Kidder JF, Pons-Villanueva J, Dynamidis S, Defranco M, Walch G. Glenoid version: how to measure it? Validity of different methods in two-dimensional computed tomography scans. J Shoulder Elbow Surg. 2010;19(8):1230-7.
Matsumura N, Ogawa K, Ikegami H, Collin P, Walch G, Toyama Y. Computed tomography measurement of glenoid vault version as an alternative measuring method for glenoid version. J Orthopaed Surg Res. 2014;9(1):17.
Edelson JG, Taitz C. Anatomy of the coraco-acromial arch. Relation to degeneration of the acromion. J Bone Joint Surg Br. 1992;74(4):589-94.
Bryce CD, Davison AC, Lewis GS, Wang L, Flemming DJ, Armstrong AD. Two-dimensional glenoid version measurements vary with coronal and sagittal scapular rotation. J Bone Joint Surg Am. 2010;92(3):692-9.
Scalise JJ, Codsi MJ, Bryan J, Iannotti JP. The three-dimensional glenoid vault model can estimate normal glenoid version in osteoarthritis. J Shoulder Elbow Surg. 2008;17(3):487-91.
Nyffeler RW, Sheikh R, Atkinson TS, Jacob HA, Favre P, Gerber C. Effects of glenoid component version on humeral head displacement and joint reaction forces: an experimental study. J Shoulder Elbow Surg. 2006;15(5):625-9.
Farron A, Terrier A, Büchler P. Risks of loosening of a prosthetic glenoid implanted in retroversion. J Shoulder Elbow Surg. 2006;15(4):521-6.
Nyffeler RW, Jost B, Pfirrmann CW, Gerber C. Measurement of glenoid version: conventional radiographs versus computed tomography scans. J Shoulder Elbow Surg. 2003;12(5):493-6.
Poon PC, Ting FS. A 2-dimensional glenoid vault method for measuring glenoid version on computed tomography. J Shoulder Elbow Surg. 2012;21(3):329-35.
Matsen FA, 3rd, Boileau P, Walch G, Gerber C, Bicknell RT. The reverse total shoulder arthroplasty. J Bone Joint Surg Am. 2007;89(3):660-7.