Dataset Information

Assessment and Evaluation of Glenoid Bone Loss.

ABSTRACT: The preoperative assessment of anterior glenoid bone loss is a critical step in surgical planning for patients with recurrent anterior glenohumeral instability. The structural integrity of the glenoid has been identified as one of the most important factors influencing the success of operative repair. The currently accepted gold standard for glenoid structural assessment among most orthopaedic surgeons is the use of 3-dimensional reconstructed computed tomography images with the humeral head digitally subtracted, yielding an en face sagittal oblique view of the glenoid. This view allows for evaluation of glenoid morphology and quantitative assessment of glenoid bone loss. In this article, we describe the practical application of ImageJ software (National Institutes of Health, Bethesda, MD) to quantify the amount of glenoid bone loss reported as a percentage of either total surface area or diameter. The following equations are used in this technical note for the diameter-based method and surface area method, respectively: Percent bone loss = (Defect width/Diameter of inferior glenoid circle) × 100% and Percent bone loss = (Defect surface area/Surface area of inferior glenoid circle) × 100%.

SUBMITTER: Hamamoto JT

PROVIDER: S-EPMC5040627 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Assessment and Evaluation of Glenoid Bone Loss.

Hamamoto Jason T JT Leroux Timothy T Chahla Jorge J Bhatia Sanjeev S Higgins John D JD Romeo Anthony A AA Yanke Adam B AB Verma Nikhil N NN

Arthroscopy techniques 20160822 4

The preoperative assessment of anterior glenoid bone loss is a critical step in surgical planning for patients with recurrent anterior glenohumeral instability. The structural integrity of the glenoid has been identified as one of the most important factors influencing the success of operative repair. The currently accepted gold standard for glenoid structural assessment among most orthopaedic surgeons is the use of 3-dimensional reconstructed computed tomography images with the humeral head dig ...[more]

PMID: 27709063

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Project description:BackgroundThe treatment of patients with severe glenoid bone loss using reverse total shoulder arthroplasty (RSA) is challenging because of the difficulty in obtaining glenoid fixation. The outcomes following primary RSA with structural bone-grafting for severe glenoid bone loss and the amount of native bone support necessary to achieve clinical improvement are unclear.MethodsWe reviewed functional outcomes (American Shoulder and Elbow Surgeons [ASES] score, Simple Shoulder Test [SST], visual analog scale [VAS] for pain and function, patient satisfaction, and range of motion) for 57 patients who were treated with a primary RSA and glenoid bone-grafting for severe glenoid bone loss. Three glenoids were classified as type A2; 2, as type B2; and 2, as type C, according to the Walch classification; 16 glenoids, as grade E1; and 19, as grade E3, according to the Sirveaux classification; 9 glenoids, as grade 3, according to the Levigne classification; and 6 were unable to be classified. For the 44 patients with adequate preoperative computed tomographic (CT) data and postoperative radiographs, we evaluated native bone contact under the glenoid baseplate by matching the projected shape of the implant and scapula from the postoperative radiographs with a generated 3-dimensional (3D) model of the preoperative scapula. We then analyzed functional outcomes in relation to native bone support of the baseplate.ResultsAt a mean of 46 months (minimum, 24 months), the patients demonstrated significant improvements in function, motion, and pain (change in the ASES total score = 38.6, change in SST = 5.4, change in forward elevation = 72.4°, change in abduction = 67.7°, change in external rotation = 24.3°, and change in VAS pain score = -4.6; p < 0.001 for all). On the basis of the generated 3D model, the baseplate contact to host bone was a mean (and standard deviation) of 17% ± 12% (range, 0% to 50%). There was no significant correlation between host bone coverage and change in the ASES score (p = 0.51) for the 44 patients included in this analysis. There were 4 major complications (7%) in the study group but no glenoid baseplate failures.ConclusionsGlenoid bone-grafting in a primary RSA in a shoulder with severe bone loss produces good functional outcomes that do not correlate with the degree of native bone contact under the baseplate. We had observed no glenoid component failures at the time of writing.Level of evidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Dataset Information

Assessment and Evaluation of Glenoid Bone Loss.

Publications

Assessment and Evaluation of Glenoid Bone Loss.

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