Habermeyer P, Magosch P, Luz V, Lichtenberg S
Department of Shoulder and Elbow Surgery, ATOS-Praxisklinik, Bismarckstrasse 9-15, 69115 Heidelberg, Germany.
J Bone Joint Surg Am. 2006 Jun;88(6):1301-7. doi: 10.2106/JBJS.E.00622.
In osteoarthritis of the shoulder, the tilt of the glenoid surface undergoes an eccentric deformation not only in the anteroposterior but also in the superoinferior direction. The goals of this study were to analyze glenoid version in the coronal plane and to clarify the relationship between retroversion and inferior inclination of the glenoid.
Standardized radiographs of 100 consecutive patients with primary osteoarthritis of the shoulder and 100 otherwise healthy patients with shoulder pain (the control group) were included in this study and were analyzed by two independent observers.
We defined four different types of inclination deformity of the glenoid. In a type-0 glenoid, a line at the base of the coracoid process and a line at the glenoid rim run parallel. Both lines intersect below the inferior glenoid rim in a type-1 glenoid. In a type-2 glenoid, the line at the base of the coracoid process and the glenoid line intersect between the inferior glenoid rim and the center of the glenoid. In a type-3 glenoid, the lines intersect above the base of the coracoid process. A significant difference (p < 0.0001) in the distribution of glenoid types between the two patient groups was observed. Forty-seven patients with osteoarthritis showed combined posterior and inferior glenoid wear. We found no correlation between the type of inclination and the type of glenoid morphology. The interobserver reliability of our observations was very high.
In osteoarthritis, eccentric inferior glenoid wear is frequent and independent from retroversion deformity of the glenoid. Normalization of glenoid version in both transverse and coronal planes may reduce eccentric loading of the prosthetic glenoid, which has been associated with loosening.
在肩关节骨关节炎中，关节盂表面的倾斜不仅在前后方向，而且在上下方向都会发生偏心变形。本研究的目的是分析冠状面的关节盂版本，并阐明关节盂后倾与下倾之间的关系。
本研究纳入了100例连续的原发性肩关节骨关节炎患者和100例有肩部疼痛的健康对照患者（对照组）的标准化X线片，并由两名独立观察者进行分析。
我们定义了四种不同类型的关节盂倾斜畸形。在0型关节盂中，喙突基部的线与关节盂边缘的线平行。在1型关节盂中，两条线在关节盂下边缘下方相交。在2型关节盂中，喙突基部的线与关节盂线在关节盂下边缘与关节盂中心之间相交。在3型关节盂中，两条线在喙突基部上方相交。观察到两组患者之间关节盂类型分布存在显著差异（p < 0.0001）。47例骨关节炎患者表现为关节盂后下部联合磨损。我们发现倾斜类型与关节盂形态类型之间没有相关性。我们观察的观察者间可靠性非常高。
在骨关节炎中，关节盂偏心性下磨损很常见，且与关节盂后倾畸形无关。在横面和冠状面使关节盂版本正常化可能会减少假体关节盂的偏心负荷，而这与松动有关。
