Matsumura Noboru, Oki Satoshi, Suzuki Taku, Iwamoto Takuji, Sato Kazuki, Nakamura Masaya, Matsumoto Morio, Nagura Takeo
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
JSES Open Access. 2018 Sep 21;2(4):194-199. doi: 10.1016/j.jses.2018.07.002. eCollection 2018 Dec.
The longitudinal axis of the glenoid is not always parallel to the scapular body, and glenoid torsion could affect the values of glenoid orientation. The purpose of this study was to evaluate 3-dimensional glenoid version and inclination modified by glenoid torsion and to clarify the differences between the values of conventional and of modified glenoid orientations.
Computed tomography scans of 30 shoulders without shoulder pathology, 30 shoulders with primary osteoarthritis, and 30 shoulders with a massive rotator cuff tear or cuff tear arthropathy were retrospectively evaluated. After determining the glenoid axis and the scapular planes and calculating conventional glenoid version and inclination, modified glenoid version and inclination, and glenoid torsion, the values of conventional glenoid orientation and those of modified glenoid orientation were compared statistically.
All shoulders showed anterior torsion of the glenoid with an average of 16° ± 5°. The values of modified glenoid retroversion were significantly smaller than those of conventional glenoid retroversion in all groups ( < .033), and the values of the modified glenoid inferior inclination were significantly larger than those of conventional glenoid inferior inclination in all groups ( < .001).
The present study showed that the glenoid twists with respect to the scapular body and that modification by glenoid torsion could affect the values of glenoid orientation. These results indicated that glenoid orientation with respect to the glenoid longitudinal axis will help surgeons determine proper placement of the glenoid component during shoulder arthroplasty.
肩胛盂的纵轴并不总是与肩胛骨体平行,肩胛盂扭转会影响肩胛盂方向的数值。本研究的目的是评估经肩胛盂扭转修正后的三维肩胛盂版本和倾斜度,并阐明传统肩胛盂方向值与修正后肩胛盂方向值之间的差异。
回顾性评估30例无肩部病变的肩部、30例原发性骨关节炎肩部以及30例巨大肩袖撕裂或肩袖撕裂性关节病肩部的计算机断层扫描。在确定肩胛盂轴和肩胛骨平面并计算传统肩胛盂版本和倾斜度、修正后的肩胛盂版本和倾斜度以及肩胛盂扭转后,对传统肩胛盂方向值和修正后的肩胛盂方向值进行统计学比较。
所有肩部均显示肩胛盂向前扭转,平均为16°±5°。在所有组中,修正后的肩胛盂后倾值均显著小于传统肩胛盂后倾值(<.033),且所有组中修正后的肩胛盂下倾斜度值均显著大于传统肩胛盂下倾斜度值(<.001)。
本研究表明,肩胛盂相对于肩胛骨体发生扭转,且肩胛盂扭转修正会影响肩胛盂方向值。这些结果表明,相对于肩胛盂纵轴的肩胛盂方向将有助于外科医生在肩关节置换术中确定肩胛盂组件的正确放置位置。