Patterson Brendan M, Galvin Joseph W, Bozoghlian Maria F, Glass Natalie, Wright Melissa
Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IA, USA.
Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
JSES Int. 2024 Nov 14;9(2):466-471. doi: 10.1016/j.jseint.2024.10.007. eCollection 2025 Mar.
Optimal glenosphere selection is critical for successful outcomes following reverse total shoulder arthroplasty (rTSA). This study primarily aimed to determine patient-specific variables associated with dimensions of native glenoid anatomy. Secondarily, we aimed to determine the distribution of glenosphere sizes selected in male and female patients with similar-sized glenoids.
Computed tomography scans from patients undergoing rTSA with a diagnosis of cuff arthropathy or irreparable cuff tears were included for analysis. Variables collected included the following: age, gender, height, weight, and glenosphere size. Glenoid dimensions were measured, and interobserver reliability was calculated. Correlation coefficients were calculated for all variables. Multivariate predictive regression models were utilized to determine correlations between patient variables and glenoid width and height.
One hundred and eighteen patients (46% male, 54% female) were included for analysis. Taller and male patients were significantly associated with increased glenoid height ( = .0096 and = .0003, respectively). Females, shorter patients, and patients with decreased body weight were significantly associated with decreased glenoid width ( = .01, < .0001, and = .01, respectively). Through stepwise selection, patient height was most strongly associated with glenoid width ( < .0001). For glenoid widths between 25 and 30 mm, there was a significant variation in selected glenosphere sizes based on gender ( < .0001).
Patient gender and height are significantly associated with glenoid height and width. There remains a strong tendency towards gender bias when selecting glenosphere sizes for patients undergoing rTSA with similar-sized glenoids. This data highlights the importance of considering patient height as well as gender when considering glenoid component size in the setting of rTSA.
对于反式全肩关节置换术（rTSA）的成功结果而言，选择最佳的关节盂假体至关重要。本研究的主要目的是确定与天然关节盂解剖结构尺寸相关的患者特异性变量。其次，我们旨在确定关节盂大小相似的男性和女性患者所选择的关节盂假体尺寸分布情况。
纳入接受rTSA且诊断为肩袖关节病或不可修复的肩袖撕裂患者的计算机断层扫描进行分析。收集的变量包括：年龄、性别、身高、体重和关节盂假体尺寸。测量关节盂尺寸，并计算观察者间信度。计算所有变量的相关系数。利用多变量预测回归模型确定患者变量与关节盂宽度和高度之间的相关性。
纳入118例患者进行分析（46%为男性，54%为女性）。较高的患者和男性患者与关节盂高度增加显著相关（分别为P = 0.0096和P = 0.0003）。女性、较矮的患者和体重减轻的患者与关节盂宽度减小显著相关（分别为P = 0.01、P < 0.0001和P = 0.01）。通过逐步选择，患者身高与关节盂宽度的相关性最强（P < 0.0001）。对于关节盂宽度在25至30毫米之间的情况，根据性别选择的关节盂假体尺寸存在显著差异（P < 0.0001）。
患者的性别和身高与关节盂的高度和宽度显著相关。在为关节盂大小相似的rTSA患者选择关节盂假体尺寸时，仍然存在强烈的性别偏见倾向。这些数据突出了在rTSA中考虑关节盂假体组件尺寸时，兼顾患者身高和性别的重要性。
