Download PDF
CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2019; 60(02): 058-066
DOI: 10.1055/s-0039-1694017
Review Article | Artículo de Revisión
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Morfologia Glenoidea En La Artrosis Glenohumeral Primaria: Factores Preoperatorios Relevantes

Glenoid Morphology in Primary Glenohumeral Osteoarthritis; Preoperatory Relevant Elements
Nicolás Moran 
1   Equipo de Artroscopia de Extremidad Superior y Cirugía de Hombro, Hospital del Trabajador de Santiago, Santiago, Chile
,
Valentina Arias 
2   Médico Cirujano, Universidad de Los Andes, Santiago, Chile
,
José Lazo
3   Residente Ortopedia y Traumatología, Hospital del Trabajador, Universidad de Chile, Santiago, Chile
,
Patricio Melean
4   Cirujano de Hombro, RedSalud Santiago y Vitacura, Santiago, Chile
› Author Affiliations
Further Information

Publication History

06 July 2018

24 June 2019

Publication Date:
08 August 2019 (online)

   Permissions and Reprints

Resumen

El objetivo primario de esta revisión es realizar una actualización de los conceptos básicos relacionados a los cambios morfológicos glenoideos durante la artrosis glenohumeral primaria, métodos de medición relevantes y describir las modificaciones en la nueva clasificación de Gilles Walch.

La medición de esos parámetros influyen en forma directa tanto en el acto quirúrgico dentro una prótesis de hombro como en los resultados clínicos post operatorios.

Los diferentes métodos de medición descritos en la literatura han permitido evaluar la magnitud de esos fenómenos morfológicos y describir la “glenoides bicóncava”, caracterizada por presentar 3 subtipos: la paleoglena, neoglena y la glena intermedia.

A partir de esos conceptos, Walch en 1999 describe la clasificación de los cambios morfológicos glenoideos en artrosis primaria, la cual ha presentado una reciente modificación debido a la mala concordancia intra e interobservador de esa medición obtenida por varios investigadores, además de reconocer una carencia en la precisión para describir cada subtipo.

A la fecha, diferentes autores investigan la influencia de esos factores morfológicos preoperatorios en los resultados post operatorios, y hasta que valor límite podrían guiar un tratamiento especifico.

Conclusión Enfatizamos que un análisis acabado y minucioso de la morfología glenoidea es importante para una adecuada planificación quirúrgica en artroplastia de hombro, ya que eso puede guiarnos en cuál técnica o implante puede ser el más adecuado para cada tipo de glenoides.

Abstract

The main purpose of this review is to up date the basic concepts regarding the glenoid morphological changes in primary glenohumeral osteoarthritis, relevant measuring methods, and a description of the modifications in the Gilles Walch classification.

The measurement of these parameters influences both surgical indications for total shoulder arthroplasty and the post op clinical outcomes.

The different measuring methods described in literature have allowed to evaluate the magnitude of these morphological phenomena describing the “biconcave glenoid”, which characteristically presents 3 subtypes: paleoglenoid, neoglenoid and intermediate glenoid.

Based on these concepts, Walch classified the glenoid morphological changes in primary ostheoarthritis in 1999, which has been recently modified due to the poor inter-observer and intra-observer reliability described by a vast number of researchers, and also because of an observed lack of precision when describing each sub-type.

Up to date, different authors are debating the influence of these pre operative morphological factors on the post op outcomes; and the cut-off value up to which this could lead to a specific treatment.

As a conclusion, we emphasize that a deep and thorough analysis of the glenoid morphology is important for an adequate surgical planning of a shoulder arthroplasty, as this can guide us to the most adequate technique and type of implant for each type of glenoid.

Palabras clave

artrosis glenohumeral - prótesis total de hombro - desgaste glenoideo - glenoides biconcave - subluxación posterior - versión glenoidea

Keywords

glenohumeral osteoarthritis - total shoulder replacement - glenoid wear - biconcave glenoid - posterior glenohumeral subluxation - glenoid version
 

  • Bibliografía

  • 1 Radnay CS, Setter KJ, Chambers L, Levine WN, Bigliani LU, Ahmad CS. Total shoulder replacement compared with humeral head replacement for the treatment of primary glenohumeral osteoarthritis: a systematic review. J Shoulder Elbow Surg 2007; 16 (04) 396-402 . Doi: 10.1016/j.jse.2006.10.017
    CrossrefPubMedGoogle Scholar
  • 2 Young A, Walch G, Boileau P. , et al. A multicentre study of the long-term results of using a flat-back polyethylene glenoid component in shoulder replacement for primary osteoarthritis. J Bone Joint Surg Br 2011; 93 (02) 210-216 . Doi: 10.1302/0301-620X.93B2.25086
    PubMedGoogle Scholar
  • 3 Strauss EJ, Roche C, Flurin P-H, Wright T, Zuckerman JD. The glenoid in shoulder arthroplasty. J Shoulder Elbow Surg 2009; 18 (05) 819-833 . Doi: 10.1016/j.jse.2009.05.008
    CrossrefPubMedGoogle Scholar
  • 4 Neer II CS, Watson KC, Stanton FJ. Recent experience in total shoulder replacement. J Bone Joint Surg Am 1982; 64 (03) 319-337
    CrossrefPubMedGoogle Scholar
  • 5 Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 1999; 14 (06) 756-760
    CrossrefPubMedGoogle Scholar
  • 6 Levine WN, Djurasovic M, Glasson JM, Pollock RG, Flatow EL, Bigliani LU. Hemiarthroplasty for glenohumeral osteoarthritis: results correlated to degree of glenoid wear. J Shoulder Elbow Surg 1997; 6 (05) 449-454
    CrossrefPubMedGoogle Scholar
  • 7 Iannotti JP, Norris TR. Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am 2003; 85 (02) 251-258
    CrossrefPubMedGoogle Scholar
  • 8 Bercik MJ, Kruse II K, Yalizis M, Gauci M-O, Chaoui J, Walch G. A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg 2016; 25 (10) 1601-1606 . Doi: 10.1016/j.jse.2016.03.010
    CrossrefPubMedGoogle Scholar
  • 9 Walch G, Ascani C, Boulahia A, Nové-Josserand L, Edwards TB. Static posterior subluxation of the humeral head: an unrecognized entity responsible for glenohumeral osteoarthritis in the young adult. J Shoulder Elbow Surg 2002; 11 (04) 309-314 . Doi: 10.1067/mse.2002.124547
    CrossrefPubMedGoogle Scholar
  • 10 Churchill RS, Brems JJ, Kotschi H. Glenoid size, inclination, and version: an anatomic study. J Shoulder Elbow Surg 2001; 10 (04) 327-332 . Doi: 10.1067/mse.2001.115269
    CrossrefPubMedGoogle Scholar
  • 11 Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 1992; 74 (07) 1032-1037
    CrossrefPubMedGoogle Scholar
  • 12 Scalise JJ, Codsi MJ, Bryan J, Iannotti JP. The three-dimensional glenoid vault model can estimate normal glenoid version in osteoarthritis. J Shoulder Elbow Surg 2008; 17 (03) 487-491 . Doi: 10.1016/j.jse.2007.09.006
    CrossrefPubMedGoogle Scholar
  • 13 Rouleau DM, Kidder JF, Pons-Villanueva J, Dynamidis S, Defranco M, Walch G. Glenoid version: how to measure it? Validity of different methods in two-dimensional computed tomography scans. J Shoulder Elbow Surg 2010; 19 (08) 1230-1237 . Doi: 10.1016/j.jse.2010.01.027
    CrossrefPubMedGoogle Scholar
  • 14 Walch G, Moraga C, Young A, Castellanos-Rosas J. Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid. J Shoulder Elbow Surg 2012; 21 (11) 1526-1533 . Doi: 10.1016/j.jse.2011.11.030
    CrossrefPubMedGoogle Scholar
  • 15 Nyffeler RW, Jost B, Pfirrmann CWA, Gerber C. Measurement of glenoid version: conventional radiographs versus computed tomography scans. J Shoulder Elbow Surg 2003; 12 (05) 493-496 . Doi: 10.1016/S1058274603001812
    CrossrefPubMedGoogle Scholar
  • 16 Denard PJ, Walch G. Current concepts in the surgical management of primary glenohumeral arthritis with a biconcave glenoid. J Shoulder Elbow Surg 2013; 22 (11) 1589-1598 . Doi: 10.1016/j.jse.2013.06.017
    CrossrefPubMedGoogle Scholar
  • 17 Kidder JF, Rouleau D, Pons-Villanueva J, Dynamidis S, DeFranco M, Walch G. Humeral Head Posterior Subluxation on CT Scan: Validation and Comparison of 2 Methods of Measurement. Techniques in Shoulder and Elbow Surgery 2010; 11 (03) 72-76 . Doi: 10.1097/BTE.0b013e3181e5d742
    CrossrefPubMedGoogle Scholar
  • 18 Edelson JG. Localized glenoid hypoplasia. An anatomic variation of possible clinical significance. Clin Orthop Relat Res 1995; (321) 189-195
    PubMedGoogle Scholar
  • 19 Nowak DD, Gardner TR, Bigliani LU, Levine WN, Ahmad CS. Interobserver and intraobserver reliability of the Walch classification in primary glenohumeral arthritis. J Shoulder Elbow Surg 2010; 19 (02) 180-183 . Doi: 10.1016/j.jse.2009.08.003
    CrossrefPubMedGoogle Scholar
  • 20 Boileau P, Avidor C, Krishnan SG, Walch G, Kempf J-F, Molé D. Cemented polyethylene versus uncemented metal-backed glenoid components in total shoulder arthroplasty: a prospective, double-blind, randomized study. J Shoulder Elbow Surg 2002; 11 (04) 351-359 . Doi: 10.1067/mse.2002.125807
    CrossrefPubMedGoogle Scholar
  • 21 Gerber C, Costouros JG, Sukthankar A, Fucentese SF. Static posterior humeral head subluxation and total shoulder arthroplasty. J Shoulder Elbow Surg 2009; 18 (04) 505-510 . Doi: 10.1016/j.jse.2009.03.003
    CrossrefPubMedGoogle Scholar
  • 22 Bryant D, Litchfield R, Sandow M, Gartsman GM, Guyatt G, Kirkley A. A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis. J Bone Joint Surg Am 2005; 87 (09) 1947-1956 . Doi: 10.2106/JBJS.D.02854
    CrossrefPubMedGoogle Scholar
  • 23 Edwards TB, Kadakia NR, Boulahia A. , et al. A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study. J Shoulder Elbow Surg 2003; 12 (03) 207-213 . Doi: 10.1016/S1058-2746(02)86804-5
    CrossrefPubMedGoogle Scholar
  • 24 Alentorn-Geli E, Wanderman NR, Assenmacher AT, Sperling JW, Cofield RH, Sánchez-Sotelo J. Anatomic total shoulder arthroplasty with posterior capsular plication versus reverse shoulder arthroplasty in patients with biconcave glenoids: A matched cohort study. J Orthop Surg (Hong Kong) 2018; 26 (02) 2309499018768570 . Doi: 10.1177/2309499018768570
    CrossrefPubMedGoogle Scholar
  • 25 Gillespie R, Lyons R, Lazarus M. Eccentric reaming in total shoulder arthroplasty: a cadaveric study. Orthopedics 2009; 32 (01) 21 . Doi: 10.3928/01477447-20090101-07
    CrossrefPubMedGoogle Scholar
  • 26 Hill JM, Norris TR. Long-term results of total shoulder arthroplasty following bone-grafting of the glenoid. J Bone Joint Surg Am 2001; 83 (06) 877-883
    PubMedGoogle Scholar
  • 27 Rice RS, Sperling JW, Miletti J, Schleck C, Cofield RH. Augmented glenoid component for bone deficiency in shoulder arthroplasty. Clin Orthop Relat Res 2008; 466 (03) 579-583 . Doi: 10.1007/s11999- 007-0104-4
    CrossrefPubMedGoogle Scholar
  • 28 Neer II CS, Morrison DS. Glenoid bone-grafting in total shoulder arthroplasty. J Bone Joint Surg Am 1988; 70 (08) 1154-1162
    CrossrefPubMedGoogle Scholar