Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2018

26.09.2016 | Shoulder

Estimation of anterior glenoid bone loss area using the ratio of bone defect length to the distance from posterior glenoid rim to the centre of the glenoid

verfasst von: Sang-Jin Shin, Bong Jae Jun, Young Won Koh, Michelle H. McGarry, Thay Q. Lee

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Estimation of anterior glenoid bone loss is important for surgical decision-making. The purpose of this study was to describe a method for estimating anterior glenoid bone loss.

Methods

Thirty-nine cadaveric glenoids were digitized to obtain glenoid geometry. Glenoid bare spot centre, arthroscopic centre, and centre of the inferior glenoid circle relative to the geometric centre were measured. To simulate anterior glenoid bone loss, imaginary sequential osteotomies were created 0°, 22.5°, and 45° to the superior–inferior line in a 3D digitizing programme. Per cent of anterior glenoid bone loss area was calculated as the percentage of defect area relative to the entire area of the glenoid. The relationship between area loss and ratio of bone defect length to the distance from posterior glenoid to various centres was determined.

Results

As the ratio of bone defect length to the distance from posterior glenoid to all three centres increased, the per cent area of bone loss increased exponentially. The ratio using the inferior circle centre and arthroscopic centre was highly correlated to the actual glenoid bone loss in all osteotomies (R 2 > 0.90). The ratio using the centre of bare area had the lowest correlation. The ratio of defect length to distance from posterior glenoid to arthroscopic centre greater than 2.4 for 0° and 2.0 for 45° osteotomies results in bone loss area greater than 25 %. The bare area centre had the largest variation. Average bone loss was overestimated when the centre of bare spot was used compared to other centre locations.

Conclusion

Per cent of anterior glenoid bone loss can be estimated using the ratio of bone defect length to the distance from posterior glenoid rim to the centre of inferior glenoid circle or arthroscopic centre either preoperatively using 3D CT or arthroscopically which can be useful for determining surgical treatment.
Literatur
1.
Zurück zum Zitat Bakshi NK, Patel I, Jacobson JA, Debski RE, Sekiya JK (2015) Comparison of 3-dimensional computed tomography-based measurement of glenoid bone loss with arthroscopic defect size estimation in patients with anterior shoulder Instability. Arthroscopy 31(10):1880–1885CrossRefPubMed Bakshi NK, Patel I, Jacobson JA, Debski RE, Sekiya JK (2015) Comparison of 3-dimensional computed tomography-based measurement of glenoid bone loss with arthroscopic defect size estimation in patients with anterior shoulder Instability. Arthroscopy 31(10):1880–1885CrossRefPubMed
2.
Zurück zum Zitat Barchilon VS, Kotz E, Barchilon Ben-Av M, Glazer E, Nyska M (2008) A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint. Skelet Radiol 37(8):731–736CrossRef Barchilon VS, Kotz E, Barchilon Ben-Av M, Glazer E, Nyska M (2008) A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint. Skelet Radiol 37(8):731–736CrossRef
3.
Zurück zum Zitat Barcia AM, Rowles DJ, Bottoni CR, Dekker TJ, Tokish JM (2013) Glenoid bare area: arthroscopic characterization and its implications on measurement of bone loss. Arthroscopy 29(10):1671–1675CrossRefPubMed Barcia AM, Rowles DJ, Bottoni CR, Dekker TJ, Tokish JM (2013) Glenoid bare area: arthroscopic characterization and its implications on measurement of bone loss. Arthroscopy 29(10):1671–1675CrossRefPubMed
4.
Zurück zum Zitat Bishop JY, Jones GL, Rerko MA, Donaldson C (2013) 3-D CT is the most reliable imaging modality when quantifying glenoid bone loss. Clin Orthop Relat Res 471(4):1251–1256CrossRefPubMed Bishop JY, Jones GL, Rerko MA, Donaldson C (2013) 3-D CT is the most reliable imaging modality when quantifying glenoid bone loss. Clin Orthop Relat Res 471(4):1251–1256CrossRefPubMed
5.
Zurück zum Zitat Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs. Arthrosc J Arthrosc Relat Surg 16(7):677–694CrossRef Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs. Arthrosc J Arthrosc Relat Surg 16(7):677–694CrossRef
6.
Zurück zum Zitat Burkhart SS, Debeer JF, Tehrany AM, Parten PM (2002) Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 18(5):488–491CrossRefPubMed Burkhart SS, Debeer JF, Tehrany AM, Parten PM (2002) Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 18(5):488–491CrossRefPubMed
7.
Zurück zum Zitat Chuang TY, Adams CR, Burkhart SS (2008) Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 24(4):376–382CrossRefPubMed Chuang TY, Adams CR, Burkhart SS (2008) Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 24(4):376–382CrossRefPubMed
8.
Zurück zum Zitat Detterline AJ, Provencher MT, Ghodadra N, Bach BR Jr, Romeo AA, Verma NN (2009) A new arthroscopic technique to determine anterior-inferior glenoid bone loss: validation of the secant chord theory in a cadaveric model. Arthroscopy 25(11):1249–1256CrossRefPubMed Detterline AJ, Provencher MT, Ghodadra N, Bach BR Jr, Romeo AA, Verma NN (2009) A new arthroscopic technique to determine anterior-inferior glenoid bone loss: validation of the secant chord theory in a cadaveric model. Arthroscopy 25(11):1249–1256CrossRefPubMed
9.
Zurück zum Zitat Gerber C, Nyffeler RW (2002) Classification of glenohumeral joint instability. Clin Orthop Relat Res 400:65–76CrossRef Gerber C, Nyffeler RW (2002) Classification of glenohumeral joint instability. Clin Orthop Relat Res 400:65–76CrossRef
10.
Zurück zum Zitat Griffith JF, Yung PS, Antonio GE, Tsang PH, Ahuja AT, Chan KM (2007) CT compared with arthroscopy in quantifying glenoid bone loss. Am J Roentgenol 189(6):1490–1493CrossRef Griffith JF, Yung PS, Antonio GE, Tsang PH, Ahuja AT, Chan KM (2007) CT compared with arthroscopy in quantifying glenoid bone loss. Am J Roentgenol 189(6):1490–1493CrossRef
11.
Zurück zum Zitat Gyftopoulos S, Beltran LS, Yemin A, Strauss E, Meislin R, Jazrawi L, Recht MP (2014) Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study. Skelet Radiol 43(2):213–218CrossRef Gyftopoulos S, Beltran LS, Yemin A, Strauss E, Meislin R, Jazrawi L, Recht MP (2014) Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study. Skelet Radiol 43(2):213–218CrossRef
12.
Zurück zum Zitat Huijsmans PE, de Witte PB, de Villiers RV, Wolterbeek DW, Warmerdam P, Kruger NR, de Beer JF (2011) Recurrent anterior shoulder instability: accuracy of estimations of glenoid bone loss with computed tomography is insufficient for therapeutic decision-making. Skelet Radiol 40(10):1329–1334CrossRef Huijsmans PE, de Witte PB, de Villiers RV, Wolterbeek DW, Warmerdam P, Kruger NR, de Beer JF (2011) Recurrent anterior shoulder instability: accuracy of estimations of glenoid bone loss with computed tomography is insufficient for therapeutic decision-making. Skelet Radiol 40(10):1329–1334CrossRef
13.
Zurück zum Zitat Huysmans PE, Haen PS, Kidd M, Dhert WJ, Willems JW (2006) The shape of the inferior part of the glenoid: a cadaveric study. J Shoulder Elb Surg 15(6):759–763CrossRef Huysmans PE, Haen PS, Kidd M, Dhert WJ, Willems JW (2006) The shape of the inferior part of the glenoid: a cadaveric study. J Shoulder Elb Surg 15(6):759–763CrossRef
14.
Zurück zum Zitat Itoi E, Lee SB, Amrami KK, Wenger DE, An KN (2003) Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography. Am J Sports Med 31(1):112–118CrossRefPubMed Itoi E, Lee SB, Amrami KK, Wenger DE, An KN (2003) Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography. Am J Sports Med 31(1):112–118CrossRefPubMed
15.
Zurück zum Zitat Kralinger F, Aigner F, Longato S, Rieger M, Wambacher M (2006) Is the bare spot a consistent landmark for shoulder arthroscopy? A study of 20 embalmed glenoids with 3-dimensional computed tomographic reconstruction. Arthroscopy 22(4):428–432CrossRefPubMed Kralinger F, Aigner F, Longato S, Rieger M, Wambacher M (2006) Is the bare spot a consistent landmark for shoulder arthroscopy? A study of 20 embalmed glenoids with 3-dimensional computed tomographic reconstruction. Arthroscopy 22(4):428–432CrossRefPubMed
16.
Zurück zum Zitat Kubicka AM, Stefaniak J, Lubiatowski P, Dlugosz J, Dzianach M, Redman M, Piontek J, Romanowski L (2016) Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability. Int Orthop. doi:10.1007/s00264-016-3253-9 PubMed Kubicka AM, Stefaniak J, Lubiatowski P, Dlugosz J, Dzianach M, Redman M, Piontek J, Romanowski L (2016) Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability. Int Orthop. doi:10.​1007/​s00264-016-3253-9 PubMed
17.
Zurück zum Zitat Lo IK, Parten PM, Burkhart SS (2004) The inverted pear glenoid: an indicator of significant glenoid bone loss. Arthroscopy 20(2):169–174CrossRefPubMed Lo IK, Parten PM, Burkhart SS (2004) The inverted pear glenoid: an indicator of significant glenoid bone loss. Arthroscopy 20(2):169–174CrossRefPubMed
18.
Zurück zum Zitat Maqdes A, Chammai Y, Lengert R, Klouche S, Clavert P, Hardy P, Kempf JF (2014) The intra- and inter-observer reliability of the CT-scan based X index to quantify glenoid bone loss in chronic anterior shoulder instability and its impact on decision making. Eur J Orthop Surg Traumatol 25:699–703CrossRefPubMed Maqdes A, Chammai Y, Lengert R, Klouche S, Clavert P, Hardy P, Kempf JF (2014) The intra- and inter-observer reliability of the CT-scan based X index to quantify glenoid bone loss in chronic anterior shoulder instability and its impact on decision making. Eur J Orthop Surg Traumatol 25:699–703CrossRefPubMed
19.
Zurück zum Zitat Miyatake K, Takeda Y, Fujii K, Takasago T, Iwame T (2014) Validity of arthroscopic measurement of glenoid bone loss using the bare spot. Open Access J Sports Med 5:37–42PubMedPubMedCentral Miyatake K, Takeda Y, Fujii K, Takasago T, Iwame T (2014) Validity of arthroscopic measurement of glenoid bone loss using the bare spot. Open Access J Sports Med 5:37–42PubMedPubMedCentral
20.
Zurück zum Zitat Moroder P, Resch H, Schnaitmann S, Hoffelner T, Tauber M (2013) The importance of CT for the pre-operative surgical planning in recurrent anterior shoulder instability. Arch Orthop Trauma Surg 133(2):219–226CrossRefPubMed Moroder P, Resch H, Schnaitmann S, Hoffelner T, Tauber M (2013) The importance of CT for the pre-operative surgical planning in recurrent anterior shoulder instability. Arch Orthop Trauma Surg 133(2):219–226CrossRefPubMed
21.
Zurück zum Zitat Pavlov H, Warren RF, Weiss CB Jr, Dines DM (1985) The roentgenographic evaluation of anterior shoulder instability. Clin Orthop Relat Res 194:153–158 Pavlov H, Warren RF, Weiss CB Jr, Dines DM (1985) The roentgenographic evaluation of anterior shoulder instability. Clin Orthop Relat Res 194:153–158
22.
Zurück zum Zitat Piasecki DP, Verma NN, Romeo AA, Levine WN, Bach BR Jr, Provencher MT (2009) Glenoid bone deficiency in recurrent anterior shoulder instability: diagnosis and management. J Am Acad Orthop Surg 17(8):482–493CrossRefPubMed Piasecki DP, Verma NN, Romeo AA, Levine WN, Bach BR Jr, Provencher MT (2009) Glenoid bone deficiency in recurrent anterior shoulder instability: diagnosis and management. J Am Acad Orthop Surg 17(8):482–493CrossRefPubMed
23.
Zurück zum Zitat Provencher MT, Bhatia S, Ghodadra NS, Grumet RC, Bach BR Jr, Dewing CB, LeClere L, Romeo AA (2010) Recurrent shoulder instability: current concepts for evaluation and management of glenoid bone loss. J Bone Joint Surg Am 92(Suppl):2133–2151 Provencher MT, Bhatia S, Ghodadra NS, Grumet RC, Bach BR Jr, Dewing CB, LeClere L, Romeo AA (2010) Recurrent shoulder instability: current concepts for evaluation and management of glenoid bone loss. J Bone Joint Surg Am 92(Suppl):2133–2151
24.
Zurück zum Zitat Provencher MT, Detterline AJ, Ghodadra N, Romeo AA, Bach BR Jr, Cole BJ, Verma N (2008) Measurement of glenoid bone loss: a comparison of measurement error between 45 degrees and 0 degrees bone loss models and with different posterior arthroscopy portal locations. Am J Sports Med 36(6):1132–1138CrossRefPubMed Provencher MT, Detterline AJ, Ghodadra N, Romeo AA, Bach BR Jr, Cole BJ, Verma N (2008) Measurement of glenoid bone loss: a comparison of measurement error between 45 degrees and 0 degrees bone loss models and with different posterior arthroscopy portal locations. Am J Sports Med 36(6):1132–1138CrossRefPubMed
25.
Zurück zum Zitat Rokous JR, Feagin JA, Abbott HG (1972) Modified axillary roentgenogram. A useful adjunct in the diagnosis of recurrent instability of the shoulder. Clin Orthop Relat Res 82:84–86CrossRefPubMed Rokous JR, Feagin JA, Abbott HG (1972) Modified axillary roentgenogram. A useful adjunct in the diagnosis of recurrent instability of the shoulder. Clin Orthop Relat Res 82:84–86CrossRefPubMed
26.
Zurück zum Zitat Saintmard B, Lecouvet F, Rubini A, Dubuc JE (2009) Is the bare spot a valid landmark for glenoid evaluation in arthroscopic Bankart surgery? Acta Orthop Belg 75(6):736–742PubMed Saintmard B, Lecouvet F, Rubini A, Dubuc JE (2009) Is the bare spot a valid landmark for glenoid evaluation in arthroscopic Bankart surgery? Acta Orthop Belg 75(6):736–742PubMed
27.
Zurück zum Zitat Saito H, Itoi E, Sugaya H, Minagawa H, Yamamoto N, Tuoheti Y (2005) Location of the glenoid defect in shoulders with recurrent anterior dislocation. Am J Sports Med 33(6):889–893CrossRefPubMed Saito H, Itoi E, Sugaya H, Minagawa H, Yamamoto N, Tuoheti Y (2005) Location of the glenoid defect in shoulders with recurrent anterior dislocation. Am J Sports Med 33(6):889–893CrossRefPubMed
28.
Zurück zum Zitat Sommaire C, Penz C, Clavert P, Klouche S, Hardy P, Kempf JF (2012) Recurrence after arthroscopic Bankart repair: Is quantitative radiological analysis of bone loss of any predictive value? Orthop Traumatol Surg Res 98(5):514–519CrossRefPubMed Sommaire C, Penz C, Clavert P, Klouche S, Hardy P, Kempf JF (2012) Recurrence after arthroscopic Bankart repair: Is quantitative radiological analysis of bone loss of any predictive value? Orthop Traumatol Surg Res 98(5):514–519CrossRefPubMed
29.
Zurück zum Zitat Stecco A, Guenzi E, Cascone T, Fabbiano F, Fornara P, Oronzo P, Grassi FA, Cecchi G, Caniggia M, Brambilla M, Carriero A (2013) MRI can assess glenoid bone loss after shoulder luxation: inter- and intra-individual comparison with CT. Radiol Med 118(8):1335–1343CrossRefPubMed Stecco A, Guenzi E, Cascone T, Fabbiano F, Fornara P, Oronzo P, Grassi FA, Cecchi G, Caniggia M, Brambilla M, Carriero A (2013) MRI can assess glenoid bone loss after shoulder luxation: inter- and intra-individual comparison with CT. Radiol Med 118(8):1335–1343CrossRefPubMed
30.
Zurück zum Zitat Sugaya H, Kon Y, Tsuchiya A (2005) Arthroscopic repair of glenoid fractures using suture anchors. Arthroscopy 21(5):635e1-e5CrossRef Sugaya H, Kon Y, Tsuchiya A (2005) Arthroscopic repair of glenoid fractures using suture anchors. Arthroscopy 21(5):635e1-e5CrossRef
31.
Zurück zum Zitat Sugaya H, Moriishi J, Dohi M, Kon Y, Tsuchiya A (2003) Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 85a(5):878–884CrossRef Sugaya H, Moriishi J, Dohi M, Kon Y, Tsuchiya A (2003) Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 85a(5):878–884CrossRef
32.
Zurück zum Zitat Sugaya H, Moriishi J, Kanisawa I, Tsuchiya A (2005) Arthroscopic osseous Bankart repair for chronic recurrent traumatic anterior glenohumeral instability. J Bone Joint Surg Am 87(8):1752–1760PubMed Sugaya H, Moriishi J, Kanisawa I, Tsuchiya A (2005) Arthroscopic osseous Bankart repair for chronic recurrent traumatic anterior glenohumeral instability. J Bone Joint Surg Am 87(8):1752–1760PubMed
Metadaten
Titel
Estimation of anterior glenoid bone loss area using the ratio of bone defect length to the distance from posterior glenoid rim to the centre of the glenoid
verfasst von
Sang-Jin Shin
Bong Jae Jun
Young Won Koh
Michelle H. McGarry
Thay Q. Lee
Publikationsdatum
26.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2018
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4312-x

Weitere Artikel der Ausgabe 1/2018

Knee Surgery, Sports Traumatology, Arthroscopy 1/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.