Bone and Joint Institute

Quantification of the position, orientation, and surface area of bone loss in type B2 glenoids

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Journal of Shoulder and Elbow Surgery

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© 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Background: The purpose of this computed tomography-based study was to quantify erosions in B2 glenoids. We hypothesized that erosions do not occur symmetrically and that they have a predictable orientation. Methods: This study evaluated 55 type B2 glenoid cases. Computed tomography data were used to create three-dimensional reconstructions, and point coordinates were extracted from each reconstruction for morphologic analysis of the osteoarthritic glenoid and humerus. Results: There was a significant difference between the mean orientation angle (28°±11°) of the posterior glenoid line of erosion and the superoinferior axis (P < .001), which resulted in the average erosion being directed toward the 8-o'clock position. On average, the erosion started 1.6±3.4mm posterior to the glenoid center point. In 35% of B2 cases, the line of erosion was curved. The mean surface area was 763±296mm2 for the neoglenoid and 957±276mm2 for the paleoglenoid, indicating that the neoglenoid occupied 44%±12% of the total glenoid area. In this cohort, the mean radius of the humeral head neoarticulation was 32±6mm, the neoglenoid radius was 37±8mm, and the paleoglenoid radius was 34±7mm. The radius of the humeral head was significantly less than that of the neoglenoid (P < .001) and the paleoglenoid (P=.009). In addition, the radius of the neoglenoid was significantly greater than the radius of the paleoglenoid (P=.012). Discussion: Type B2 glenoids have a predictable wear pattern, which is not axisymmetric to the glenoid superoinferior axis. In addition, the identified anatomic characteristics of B2 erosions will aid surgeons in the operative management of bone loss and may assist manufacturers in the design of augmented components.

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