Journal article
Different acromial roof morphology in concentric and eccentric osteoarthritis of the shoulder: a multiplane reconstruction analysis of 105 shoulder computed tomography scans.
- Beeler S Department of Orthopaedic Surgery, University of Zürich, Balgrist University Hospital, Zürich, Switzerland. Electronic address: silvan.beeler@balgrist.ch.
- Hasler A Department of Orthopaedic Surgery, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
- Götschi T Department of Orthopaedic Surgery, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
- Meyer DC Department of Orthopaedic Surgery, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
- Gerber C Department of Orthopaedic Surgery, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
- 2018-07-29
Published in:
- Journal of shoulder and elbow surgery. - 2018
B2 glenoid
Critical shoulder angle
acromion morphology
glenoid wear
lateral acromial roof
osteoarthritis
shape of acromion
shape of scapula
Acromion
Aged
Aged, 80 and over
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Osteoarthritis
Rotation
Shoulder Joint
Tomography, X-Ray Computed
English
BACKGROUND
The pathomechanisms of eccentric osteoarthritis of the shoulder remain unclear. Although there is increasing evidence of bony differences between shoulders with rotator cuff tears and osteoarthritis, analogous differences have not been identified for primary concentric and eccentric osteoarthritis. This study examined the shape and orientation of the acromial roof as a potential risk factor for the development of posterior glenoid wear.
METHODS
We analyzed computed tomography images of 105 shoulders with primary osteoarthritis. Based on the classification of Walch, 45 shoulders had concentric osteoarthritis (Walch A) and 60 shoulders were affected by eccentric osteoarthritis (Walch B; EOA). A comparison of acromial morphology was performed in a multiplanar reconstruction analysis of computed tomography scans.
RESULTS
Acromial shape: Acromial length, width, and area were not significantly different. Acromial roof orientation: The acromial roof in EOA was an average of 5° flatter (sagittal tilt; P < .01) and 5° more downward tilted (coronal tilt; P < .01). There was no difference in axial rotation (axial tilt; P = .47). Anteroposterior glenoid coverage: The glenoid in EOA was covered an average of 4° less posteriorly (P = .01) and 4° more anteriorly (P = .04). No differences were shown for overall glenoid coverage.
CONCLUSIONS
The acromial roof could play a role in the pathogenesis of EOA. Less posterior support due to a flatter acromion with less posterior glenoid coverage could contribute to static posterior subluxation of the humeral head and posterior glenoid wear. Further biomechanical investigations are needed to confirm these findings.
The pathomechanisms of eccentric osteoarthritis of the shoulder remain unclear. Although there is increasing evidence of bony differences between shoulders with rotator cuff tears and osteoarthritis, analogous differences have not been identified for primary concentric and eccentric osteoarthritis. This study examined the shape and orientation of the acromial roof as a potential risk factor for the development of posterior glenoid wear.
METHODS
We analyzed computed tomography images of 105 shoulders with primary osteoarthritis. Based on the classification of Walch, 45 shoulders had concentric osteoarthritis (Walch A) and 60 shoulders were affected by eccentric osteoarthritis (Walch B; EOA). A comparison of acromial morphology was performed in a multiplanar reconstruction analysis of computed tomography scans.
RESULTS
Acromial shape: Acromial length, width, and area were not significantly different. Acromial roof orientation: The acromial roof in EOA was an average of 5° flatter (sagittal tilt; P < .01) and 5° more downward tilted (coronal tilt; P < .01). There was no difference in axial rotation (axial tilt; P = .47). Anteroposterior glenoid coverage: The glenoid in EOA was covered an average of 4° less posteriorly (P = .01) and 4° more anteriorly (P = .04). No differences were shown for overall glenoid coverage.
CONCLUSIONS
The acromial roof could play a role in the pathogenesis of EOA. Less posterior support due to a flatter acromion with less posterior glenoid coverage could contribute to static posterior subluxation of the humeral head and posterior glenoid wear. Further biomechanical investigations are needed to confirm these findings.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jse.2018.05.019
- PMID 30054240
- Persistent URL
- https://sonar.ch/global/documents/299045
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