Department of Orthopedic and Trauma Surgery, University Hospital Cologne, Kerpener Street 62, 50937, Cologne, Germany.
Department of Orthopedic and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
Arch Orthop Trauma Surg. 2022 Mar;142(3):387-393. doi: 10.1007/s00402-020-03642-w. Epub 2020 Oct 28.
Joint replacement surgery as a treatment for glenohumeral arthritis with glenoid bone loss is challenging. The aim of this study is to offer an anatomical orientation for glenoid reconstruction.
In this study, we measured size, inclination and version of the glenoid surface, as well as the distance between the articular line of the glenoid, base of the coracoid process, and acromion using computer tomographic (CT) imaging of 131 study participants aged 19-88 years in the period of 2010-2013.
We measured a mean distance of 6.5 ± 0.2 mm from the glenoid articular line to the base of the coracoid process in the transverse CT plane. Body height has shown no significant impact on the glenoid morphology. We observed significant differences between males and females: The glenoid appeared to be located 5.2 ± 0.9 mm higher and the humeral head was 4.5 ± 0.7 mm larger in male subjects compared with females (r = .699; p < .01).
In our study, the base of the coracoid offers an anatomical reference during reconstruction of the glenoid in primary and revision shoulder arthroplasty. As only 2D-CT imaging allows for accurate assessment of glenoid bone defects, we consider conventional X-ray imaging insufficient for proper preoperative planning before shoulder arthroplasty.
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关节置换手术是治疗伴有肩胛盂骨缺损的肩关节炎的一种方法，但具有挑战性。本研究旨在为肩胛盂重建提供解剖学定位。
在这项研究中，我们通过对 2010 年至 2013 年期间的 131 名 19 至 88 岁研究参与者的计算机断层扫描（CT）图像进行测量，得到了肩胛盂表面的大小、倾斜度和版本，以及肩胛盂关节线、喙突基底和肩峰之间的距离。
我们在横断 CT 平面上测量到，从肩胛盂关节线到喙突基底的平均距离为 6.5±0.2mm。身高对肩胛盂形态没有显著影响。我们观察到男性和女性之间存在显著差异：与女性相比，男性肩胛盂的位置高 5.2±0.9mm，肱骨头大 4.5±0.7mm（r=.699；p<.01）。
在我们的研究中，喙突基底在初次和翻修肩关节置换术中重建肩胛盂时提供了一个解剖学参考。由于只有 2D-CT 成像才能准确评估肩胛盂骨缺损，我们认为在肩关节置换术前常规 X 线成像不足以进行适当的术前规划。
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