Original ArticlesGlenoid size, inclination, and version: An anatomic study*
Introduction
Glenoid orientation, or version, has been implicated as a contributing factor in glenohumeral instability in multiple studies.2, 3, 4, 7, 8 However, the precise size and orientation of the glenoid fossa are not well defined. Studies to date have varied, from small-scale cadaveric measurements to radiography and computed axial tomography (CT) calculation of glenoid version.1, 2, 3, 4, 5, 7, 8 The most recent investigations have used CT technology and precise definitions of scapular positioning for more reproducible and accurate measurements.1, 5, 7 Despite this, several of these studies have conflicting results.1, 5, 7 To date, however, no large-scale studies of the glenoid geometry measuring both size and orientation have been performed.
The purpose of this study was to determine the anatomical size and orientation of the glenoid precisely, as well as quantify any variation based on race or sex. In addition, 2 different described scapular positions will be compared to determine the measured glenoid version variation due solely to the particular reference points used.
Section snippets
Materials and methods
One hundred seventy-two pairs of scapular bones were obtained from the Hamann-Todd Osteological Collection at the Museum of Natural History, in Cleveland, Ohio. This collection contains skeletons of Cleveland's unclaimed dead from 1912 through 1938. For the purpose of this study, only those persons who were aged 20 to 30 years at the time of death were studied. This would ensure skeletal maturity and minimize the possibility of degenerative osteophytes altering glenoid morphology. The specimens
Results
No specimens had osteophytes. As determined from the original historical data, the average male height and weight were 173.0 cm and 60.3 kg, respectively. The average female height and weight were 161.3 cm and 50.1 kg, respectively. The mean age for the entire study population was 25.6 years.
The glenoid dimensions were not found to vary between the 2 races studied. The male glenoid width and height were 27.8 ± 1.6 mm (mean ± SD) (range, 24.3-32.5 mm) and 37.5 ± 2.2 mm (range, 30.4-42.6 mm),
Discussion
Several authors have attempted to determine glenoid version.1, 2, 3, 4, 5, 7, 8 This has been performed in a variety of ways, including direct measurement of dry scapulae, 4 radiographic (x-ray)2, 3, 8 measurement, and more recently CT.1, 5, 7 These separate studies have often compared “normal” subjects with those with glenohumeral osteoarthritis5 or those with anterior or posterior instability. 2, 3, 7
In 1966 50 dry scapulae were measured directly to evaluate glenoid version.4 A Martin's
References (8)
- et al.
Variability of measurement of glenoid version on computed tomography scan
J Shoulder Elbow Surg
(1999) - et al.
Excessive retroversion of the glenoid cavity. A cause of non-traumatic posterior instability of the shoulder
J Bone Joint Surg Am
(1986) - et al.
Humeral retroversion and glenohumeral relationship in the normal shoulder and in recurrent anterior dislocation (scapulometry)
Clin Orthop
(1983) - et al.
Observations on the tilt of the glenoid cavity of scapula
J Anat Soc India
(1966)
Cited by (322)
Preoperative planning and its role in anatomic total shoulder arthroplasty
2024, Seminars in Arthroplasty JSESComputer navigation in shoulder arthroplasty
2023, Seminars in Arthroplasty JSESHow should I be putting my anatomic glenoids in? What we know and what we do not know
2023, Seminars in Arthroplasty JSESImpact of age on glenoid size: three-dimensional computed tomographic analysis of glenoid anatomy
2023, Seminars in Arthroplasty JSESOutcomes of femoral head allograft for the management of glenoid bone defects in revision reverse shoulder arthroplasty: a case-controlled study
2023, Journal of Shoulder and Elbow Surgery
- *
Reprint requests: John J. Brems, MD, Section of Adult Reconstruction, Department of Orthopaedic Surgery, A41, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195.