The base of coracoid process as a reference for glenoid reconstruction in primary or revision reverse shoulder arthroplasty: CT-based anatomical study.

INTRODUCTION

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

LEVEL OF EVIDENCE

III.