A three-dimensional comparative study on the scapulohumeral relationship in normal and osteoarthritic shoulders

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• 作者：Matthijs Jacxsens ; MD^a ; ^b ; ^{matthijs.jacxsens@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Alexander Van Tongel ; MD ; PhD^a ; Heath B. Henninger ; PhD^c ; Brecht De Coninck ; MD^d ; Andreas M. Mueller ; MD^b ; Lieven De Wilde ; MD ; PhD^a
• 关键词：Basic Science Study ; Anatomy Study ; Imaging
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：25
• 期：10
• 页码：1607-1615
• 全文大小：1099 K

文摘

Eccentric loading due to humeral translation is associated with worse clinical outcomes in hemiarthroplasty and total shoulder arthroplasty. The purpose of this study was to evaluate the 3-dimensional relationship of the humeral head to the scapula (scapulohumeral relationship) in nonpathologic shoulders and in shoulders with primary osteoarthritis.

Materials and Methods

Three-dimensional reconstructions of computed tomography scans of 151 nonpathologic shoulders (control group) and 110 shoulders with primary glenohumeral arthritis (OA group) were analyzed by measuring the anterior-posterior, inferior-superior, and medial-lateral position of the humeral head in relation to the scapula. Shoulders were classified as centered (type A) or posteriorly subluxed (type B) according to the Walch classification of glenoid morphology. Reproducibility and differences in scapulohumeral relationship were statistically analyzed.

Results

The scapulohumeral relationship could be determined reliably: the intraclass correlation coefficient ranged between 0.780 and 0.978; the typical error of measurement ranged between 2.4% and 5.0%. Both type A and type B shoulders showed significant posterior translation of the humeral head (P < .001). Type B shoulders had significantly more posterior translation than type A shoulders (P < .001). A tendency of inferior translation was noted, although with only marginal statistical significance (P = .051). In each morphology class, a medial deviation of the humeral head, representing a reduced glenohumeral distance, was measured (P < .001).

Conclusions

The main characteristics of primary glenohumeral osteoarthritis are posterior humeral head translation relative to the scapula, reduced glenohumeral distance, and a tendency toward inferior humeral head translation in both type A and type B shoulders.