Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Surgery

Supervisor

Dr Louis M Ferreira

2nd Supervisor

Dr George Athwal

Joint Supervisor

Abstract

Baseplate fixation in a reverse shoulder arthroplasty depends on adequate bone stock. In cases of severe glenoid bone loss and revision shoulder arthroplasty, deficiency of the glenoid vault compels the surgeon to attain screw fixation in the three columns of the scapula. The relationship of these columns demonstrated that the coracoid is closer to the lateral scapular pillar in females than in males. Significant gender dimorphism exists between the orientations of the three columns. The gender dimorphism is further evaluated by anthropometric measurements of the scapular body and the glenoid. The clinical significance lies in the ability to reconstruct the glenoid to its premorbid anatomy, there by being able to predict the glenoid dimensions from scapular body dimensions.

Adequate positioning of the glenoid baseplate requires it to be positioned orthogonal to the scapular plane. Typically, calculation of the scapular plane relies on the glenoid being intact. As such, the scapular plane cannot be recreated if the glenoid has an abnormal morphology. This mandates the utilization of alternate planes that are independent of glenoid reference points. A relationship between the various planes independent of the glenoid reference points and the current scapular plane dependent upon the normal glenoid anatomy has been established.

Keywords

Reverse Shoulder Arthroplasty, Baseplate position, Screw Position, Glenoid bone loss, shoulder, revision, Scapular plane, ISB axis, 3 columns of scapula, gender dimorphism

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