Department of Development and Regeneration, KU Leuven, Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium.
Department of Development and Regeneration, KU Leuven, Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium.
J Shoulder Elbow Surg. 2021 Sep;30(9):e558-e571. doi: 10.1016/j.jse.2021.01.018. Epub 2021 Feb 16.
Shoulder osteoarthritis can be divided into different glenoid types (A, B, C, and D) and subtypes. The aim of this study was to investigate if there is an association between the prearthropathy scapular anatomy, shoulder osteoarthritis, and different glenoid types and subtypes.
Using principal components analysis, a statistical shape model (SSM) of the scapula was constructed from a data set of 110 computed tomographic (CT) scans. These subjects formed the control group. Next, CT scan images of 117 patients with osteoarthritis were classified according to the modified Walch classification. A complete 3-dimensional (3D) scapular bone model was created for every patient, and using the SSM, a reconstruction of their prearthropathy scapular anatomy was performed. Automated 3D measurements were performed in both the patient and control group to obtain glenoid version and inclination, critical shoulder angle (CSA), posterior acromial slope (PAS), lateral acromion angle, scapular offset, and the rotational alignment of the coracoacromial complex. These parameters were compared between controls, patients with osteoarthritis, and glenoid types and subtypes.
Mean version and inclination for the control group was 6° retroversion and 8° superior inclination (both SD 4°). The mean CSA, PAS, coracoid-posterior acromion angle, posterior acromion-scapular plane angle, and fulcrum axis ratio were 30° (SD 4°), 64° (SD 8°), 116° (SD 9°), 55° (SD 7°), and 46% (SD 4%), respectively. Patients with osteoarthritis had a significant lower CSA, posterior acromion-scapular plane angle, coracoid-posterior acromion angle, and fulcrum axis ratio (27°, 50°, 111°, and 44%, all P < .001). We found a significant difference between the control group and the respective glenoid types for the following parameters: mean CSA and coracoid-posterior acromion angle for A glenoids (27°, P = .001, and 111°, P = .007); mean version, CSA, PAS, coracoid-posterior acromion angle, posterior acromion-scapular plane angle, and fulcrum axis ratio for B glenoids (11°, 27°, 71°, 111°, 49°, and 43%, all P < .001); and mean version, CSA, and posterior acromion-scapular plane angle for D glenoids (2°, P = .002, 26°, P = .003, and 48°, P = .007).
There seems to be an association between prearthropathy scapular anatomy and shoulder osteoarthritis. A small lateral extension and less posterior rotation of the acromion is associated with shoulder osteoarthritis and is present in almost all types and subtypes of glenoid morphology. Furthermore, B and D glenoids are associated with, respectively, a more and less pronounced prearthropathy glenoid retroversion.
肩关节炎可分为不同的肩胛盂类型（A、B、C 和 D）和亚型。本研究的目的是探讨在骨关节炎前期肩胛骨解剖、肩关节炎和不同的肩胛盂类型和亚型之间是否存在关联。
使用主成分分析，从 110 个 CT 扫描的数据集构建了肩胛的统计形状模型（SSM）。这些对象构成了对照组。接下来，根据改良 Walch 分类法对 117 名骨关节炎患者的 CT 扫描图像进行分类。为每位患者创建了完整的 3 维（3D）肩胛骨模型，并使用 SSM 对其骨关节炎前期肩胛解剖结构进行重建。在患者和对照组中都进行了自动的 3D 测量，以获得肩胛盂的倾斜度和倾斜度、临界肩角（CSA）、后肩峰斜率（PAS）、外侧肩峰角、肩胛偏距和肩峰下关节复合体的旋转对准。比较了对照组、骨关节炎患者以及肩胛盂类型和亚型之间的这些参数。
对照组的平均倾斜度和倾斜度分别为 6°后倾和 8°上倾（均为 4°标准差）。平均 CSA、PAS、喙突-后肩峰角、后肩峰-肩胛平面角和支轴比分别为 30°（4°标准差）、64°（8°标准差）、116°（9°标准差）、55°（7°标准差）和 46%（4%标准差）。骨关节炎患者的 CSA、后肩峰-肩胛平面角、喙突-后肩峰角和支轴比显著降低（27°、50°、111°和 44%，均 P<.001）。我们发现对照组和各自的肩胛盂类型之间在以下参数上存在显著差异：A 型肩胛盂的平均 CSA 和喙突-后肩峰角（27°，P =.001，111°，P =.007）；B 型肩胛盂的平均倾斜度、CSA、PAS、喙突-后肩峰角、后肩峰-肩胛平面角和支轴比（11°、27°、71°、111°、49°和 43%，均 P<.001）；D 型肩胛盂的平均倾斜度、CSA 和后肩峰-肩胛平面角（2°、P =.002、26°、P =.003 和 48°、P =.007）。
在骨关节炎前期肩胛骨解剖和肩关节炎之间似乎存在关联。肩峰的外侧延伸较小和后旋转较少与肩关节炎有关，并且存在于几乎所有类型和亚型的肩胛盂形态中。此外，B 和 D 型肩胛盂分别与更明显和不明显的骨关节炎前期肩胛盂后倾有关。
