Original Articles
Glenoid size, inclination, and version: An anatomic study*

https://doi.org/10.1067/mse.2001.115269Get rights and content

Abstract

Three hundred forty-four human scapular bones (172 matched pairs) were measured for their glenoid height, width, inclination, and version. The sample consisted of 50 black men, 50 white men, 50 black women, and 22 white women, all of whom were aged 20 to 30 years at the time of death. The mean age of the study group was 25.6 years. No difference in glenoid size was noted between black and white patients. The overall glenoid version for the entire study group was 1.23° of retroversion. The difference in glenoid version between black and white patients was statistically significant. The average glenoid version for black and white patients measured 0.20° and 2.65° of retroversion, respectively (P =.000014). Specifically, the glenoid version for black and white men measured 0.11° and 2.87° of retroversion, respectively (P =.00034). The glenoid version for black and white women measured 0.30° and 2.16° of retroversion, respectively (P =.034). No statistical difference in glenoid version was found between men and women of the same race. No difference was found between measuring the glenoid version based on the transverse axis of the scapula and measuring the glenoid version perpendicular to the glenohumeral joint. No statistical difference was found in the glenoid inclination based on race or sex. The relationships between glenoid size, inclination, and version are important to understand when a surgeon prepares to resurface the glenoid during total shoulder arthroplasty. The knowledge of these values, their variation, and racial differences should help reproduce a more anatomical result. (J Shoulder Elbow Surg 2001;10:327-32.)

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

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Reprint requests: John J. Brems, MD, Section of Adult Reconstruction, Department of Orthopaedic Surgery, A41, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195.

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