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Mangasah H, Aminata IW. Three-dimensional morphometric analysis of glenoid in the Indonesian population and its clinical significance. J Orthop 2023; 37:27-33. [PMID: 36974093 PMCID: PMC10039108 DOI: 10.1016/j.jor.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/29/2022] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
Background Understanding glenoid morphometry is important in shoulder prosthetic replacement surgery. In total and reverse shoulder arthroplasty, the size of the implants has to be determined according to the morphometry of the shoulder. However, there has been no known data on glenoid morphometry in the Indonesian population. Methods Seventy-four computed tomography scans of asymptomatic shoulders were obtained from the medical databases of a third referral hospital in Jakarta. Mimics Research 21.0 was used to reconstruct 3D models of the scapula from the DICOM files. The morphometry parameters included were glenoid fossa height (GFH), maximum glenoid fossa width (MGW), glenoid width at center of the glenoid fossa (CGW), vertical distance between maximum width and center (VDMC), glenoid version angle (GVA), glenoid inclination (GI), glenopolar angle (GPA), glenoid vault depth (GVD), coracoid length (CL), coracoid midpoint length (CML), coracoid tip height (CTH) and width (CTW), and coracoid midpoint height (CMH) and width (CMW). Results Our study found the average Indonesian GFH was 30.24 mm, the MGW was 24.03 mm, the CGW was 22.46 mm, the VDMC was 3.67 mm, the GPA was 42.76°, the GVD 18.8 mm, the GVA was 2.39° retroverted, the GI was 3.15° superiorly inclined, the CL was 37.76 mm, the CML was 18.89 mm, the CTW was 13.31 mm, the CTH was 8.52 mm, the CMW was 14.21 mm, and the CMH was 10.46 mm. All parameters except VDMC, GVA, and GI showed significant differences between male and female subjects Meanwhile, there was no significant difference in dimension and orientation of the glenoid and coracoid between the right and left shoulder. Conclusion Our study showed a lower value of MGW, GFH, and GVD compared to other Asian ethnicities. These results may be helpful in designing smaller prostheses suitable for Indonesian glenoids.
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Affiliation(s)
- Holong Mangasah
- Department of Orthopaedics and Traumatology, Fatmawati General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Iman Widya Aminata
- Department of Orthopaedics and Traumatology, Fatmawati General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Heilmann LF, Sussiek J, Raschke MJ, Langer MF, Frank A, Wermers J, Michel PA, Dyrna F, Schliemann B, Katthagen JC. Biomechanical Analysis of Coracoid Stability After Coracoplasty: How Low Can You Go? Orthop J Sports Med 2022; 10:23259671221077947. [PMID: 35340899 PMCID: PMC8951046 DOI: 10.1177/23259671221077947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Arthroscopic coracoplasty is a procedure for patients affected by subcoracoid
impingement. To date, there is no consensus on how much of the coracoid can
be resected with an arthroscopic burr without compromising its
stability. Purpose: To determine the maximum amount of the coracoid that can be resected during
arthroscopic coracoplasty without leading to coracoid fracture or avulsion
of the conjoint tendon during simulated activities of daily living
(ADLs). Study Design: Controlled laboratory study. Methods: A biomechanical cadaveric study was performed with 24 shoulders (15 male, 9
female; mean age, 81 ± 7.9 years). Specimens were randomized into 3
treatment groups: group A (native coracoid), group B (3-mm coracoplasty),
and group C (5-mm coracoplasty). Coracoid anatomic measurements were
documented before and after coracoplasty. The scapula was potted, and a
traction force was applied through the conjoint tendon. The stiffness and
load to failure (LTF) were determined for each specimen. Results: The mean coracoid thicknesses in groups A through C were 7.2, 7.7, and 7.8
mm, respectively, and the mean LTFs were 428 ± 127, 284 ± 77, and 159 ± 87
N, respectively. Compared with specimens in group A, a significantly lower
LTF was seen in specimens in group B (P = .022) and group C
(P < .001). Postoperatively, coracoids with a
thickness ≥4 mm were able to withstand ADLs. Conclusion: While even a 3-mm coracoplasty caused significant weakening of the coracoid,
the individual failure loads were higher than those of the predicted ADLs. A
critical value of 4 mm of coracoid thickness should be preserved to ensure
the stability of the coracoid process. Clinical Relevance: In correspondence with the findings of this study, careful preoperative
planning should be used to measure the maximum reasonable amount of
coracoplasty to be performed. A postoperative coracoid thickness of 4 mm
should remain.
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Affiliation(s)
| | - Julia Sussiek
- University Hospital Muenster (WWU), Muenster, Germany
| | | | | | - Andre Frank
- University Hospital Muenster (WWU), Muenster, Germany
| | - Jens Wermers
- University Hospital Muenster (WWU), Muenster, Germany
| | | | - Felix Dyrna
- University Hospital Muenster (WWU), Muenster, Germany
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Sarı A, Sasani H, Çetin MÜ, Günaydin B, Kilinç S, Yildirim I, Dinçel YM. Analysis of the coracoid morphology with multiplanar 2D CT and its effects on the graft size in the Latarjet procedure. J Orthop Surg (Hong Kong) 2021; 28:2309499020964602. [PMID: 33150837 DOI: 10.1177/2309499020964602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE In this study, we aimed to reveal the individual differences regarding the size of the coracoid and their effects on the classical and modified Latarjet procedures. METHODS Computed tomography images of 120 patients (mean age: 41.18 ± 12.01 years) without shoulder complaints or shoulder instability were evaluated retrospectively. The glenoid width, the surgical graft length, and the coracoid total length, width, and thickness were measured using the multiplanar reconstruction method on the Sectra Picture Archiving and Communications System (PACS) system. Age, gender, side, the dominant hand, and the height of the patients were recorded and the correlations between them were investigated. On the created hypothetical model, the current size of the coracoid was evaluated to determine what size of glenoid defects it could repair by employing the classical and the modified Latarjet techniques. RESULTS There was no significant difference between the right-hand-dominant group and the left-hand-dominant group in terms of coracoid measurement results (p > 0.05). Again, there was no statistically significant difference between the right and the left side regarding the coracoid size (p > 0.05). A positive correlation could be detected only between age and the coracoid width and thickness (p < 0.05). A positive correlation was also found between the glenoid width and the coracoid width and thickness in both shoulders (p < 0.001). Coracoid thickness could fill in the defects that amounted to 40% of the glenoid width, while the coracoid width could fill in for the defects that were 50% of the glenoid width in both genders. CONCLUSION Our study showed that hand dominance and side were not effective on the coracoid dimensions. In addition, it has been shown that the coracoid dimensions did not have a significant effect in the choice of Latarjet technique in terms of defect repair and that repair rates of up to 40% could be achieved in glenoid defects with both techniques.
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Affiliation(s)
- Abdulkadir Sarı
- Department of Orthopedics and Traumatology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Hadi Sasani
- Department of Radiology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Mehmet Ümit Çetin
- Department of Orthopedics and Traumatology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Burak Günaydin
- Department of Orthopedics and Traumatology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Seyran Kilinç
- Department of Orthopedics and Traumatology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Ilker Yildirim
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Yaşar Mahsut Dinçel
- Department of Orthopedics and Traumatology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
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Frank RM, Salem HS, Richardson C, O'Brien M, Newgren JM, Cole BJ, Verma NN, Nicholson GP, Romeo AA. Clinical Outcomes of Shoulder Stabilization in Females With Glenoid Bone Loss. Orthop J Sports Med 2021; 9:23259671211007525. [PMID: 34036113 PMCID: PMC8127764 DOI: 10.1177/23259671211007525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/21/2020] [Indexed: 01/06/2023] Open
Abstract
Background Nearly all studies describing shoulder stabilization focus on male patients. Little is known regarding the clinical outcomes of female patients undergoing shoulder stabilization, and even less is understood about females with glenoid bone loss. Purpose To assess the clinical outcomes of female patients with recurrent anterior shoulder instability treated with the Latarjet procedure. Study Design Case series; Level of evidence, 4. Methods All cases of female patients who had recurrent anterior shoulder instability with ≥15% anterior glenoid bone loss and underwent the Latarjet procedure were analyzed. Patients were evaluated after a minimum 2-year postoperative period with scores of the American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and pain visual analog scale. Results Of the 22 patients who met our criteria, 5 (22.7%) were lost to follow-up, leaving 17 (77.2%) available for follow-up with a mean ± SD age of 31.7 ± 12.9 years. Among these patients, 16 (94.1%) underwent 1.6 ± 0.73 ipsilateral shoulder operations (range, 1-3) before undergoing the Latarjet procedure. Preoperative indications for surgery included recurrent instability with bone loss in all cases. After a mean follow-up of 40.2 ± 22.9 months, patients experienced significant score improvements in the American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and pain visual analog scale (P < .05 for all). There were 2 reoperations (11.8%). There were no cases of neurovascular injuries or other complications. Conclusion Female patients with recurrent shoulder instability with glenoid bone loss can be successfully treated with the Latarjet procedure, with outcomes similar to those of male patients in the previously published literature. This information can be used to counsel female patients with recurrent instability with significant anterior glenoid bone loss.
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Affiliation(s)
- Rachel M Frank
- Department of Orthopaedic Surgery, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Hytham S Salem
- Department of Orthopaedic Surgery, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Catherine Richardson
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Michael O'Brien
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Jon M Newgren
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Brian J Cole
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Nikhil N Verma
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Gregory P Nicholson
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Anthony A Romeo
- Department of Orthopaedic Surgery, DuPage Medical Group, Joliet, Illinois, USA
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Minuesa-Asensio A, García-Esteo F, Mérida-Velasco JR, Barrio-Asensio C, de la Cuadra-Blanco C, Murillo-González J. Basic morphological characteristics of coracoid grafts obtained by open and arthroscopic Latarjet techniques: A comparative study. Orthop Traumatol Surg Res 2020; 106:1083-1087. [PMID: 32763008 DOI: 10.1016/j.otsr.2020.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 04/12/2020] [Accepted: 04/23/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND A knowledge of the anthropometric characteristics of the coracoid graft (CG) that can be obtained by the open and arthroscopic Latarjet techniques may be beneficial in the preoperative planning and intraoperative decision making for coracoid osteotomy and transfer. We have not found any study that compared the morphology of the CG that can be obtained from open and arthroscopic Latarjet techniques. The purpose of this study was to verify if the basic anthropometric characteristics of CGs are equivalent. HYPOTHESIS We hypothesize that the basic anthropometric characteristics of the CGs are similar. METHODS Twenty fresh-frozen human paired cadaveric shoulder specimens that had been randomly distributed in two groups of 10 specimens each were used. Two surgeons, each with experience in performing the open and arthroscopic Latarjet technique, performed these procedures in each of the respective groups (OG, open group; AG, arthroscopic group). A CT scan was performed. Using the volume rendering technique, a metric analysis of the volume, area and length of the CG were performed, evaluated and statistically analysed. RESULTS There were no significant differences in length (p=0.162) (mean length, 22.6mm for OG and 23.6mm for AG). There were significant differences in the volume (p=0.031) and area (p=0.007) of the CG, being lower in the OG (mean volume, 2.8 cm3 for OG and 3.6 cm3 for AG; mean area, 9.9 cm2 for OG and 12.8 cm2 for AG). No significant differences were observed by sex or laterality. CONCLUSION The mean lengths of the CGs that were obtained by each technique are equivalent. However, the areas and volumes of the grafts are different, being lower in the open surgery. These differences have not been an impediment to perform the technique. Our results corroborates that consolidation is more related to the preparation and placement than to the anthropometric characteristics of the CG. No significant differences were observed by sex or laterality. LEVEL OF EVIDENCE Basic Science.
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Affiliation(s)
| | | | - José Ramón Mérida-Velasco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Carmen Barrio-Asensio
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Crótida de la Cuadra-Blanco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Jorge Murillo-González
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
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Morphological characteristics of Malaysian Malay shoulders for the Latarjet procedure: A cross-sectional CT scan based study. CURRENT ORTHOPAEDIC PRACTICE 2020. [DOI: 10.1097/bco.0000000000000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jia Y, He N, Liu J, Zhang G, Zhou J, Wu D, Wei B, Yun X. Morphometric analysis of the coracoid process and glenoid width: a 3D-CT study. J Orthop Surg Res 2020; 15:69. [PMID: 32093704 PMCID: PMC7038565 DOI: 10.1186/s13018-020-01600-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/13/2020] [Indexed: 11/24/2022] Open
Abstract
Background Data regarding the parameters of the coracoid process and glenoid width are insufficient, and information on gender, age, and ethnic differences in the parameters appear lacking in the Chinese population. This study aimed to investigate the morphometric parameters in the coracoid process and glenoid width. Methods Using our institution’s electronic database, we selected 84 patients (55 males and 29 females) who underwent a shoulder computed tomography (CT) scan from January 2017 to May 2018 in this study. Mimics19.0 software was used for three-dimensional (3D) reconstruction of CT and to measure the morphometric parameters of the coracoid process and glenoid width. Subgroup analyses stratified by gender and age were conducted and the parameters were compared with previously published reports. All data were statistically analysed by SPSS23.0 Statistical Package. Results A positive and significant relationship between the coracoid process and the glenoid width (R > 0.758, P < 0.01) was found. The midpoint width represents 52% (41–62%) of the glenoid width; the midpoint height, 40% (31–53%) of the glenoid width. Significant differences in all parameters between males and females were noted (P < 0.05). No significant differences among the age groups were observed (P > 0.05), whereas significant differences in almost all parameters between the ethnic groups were observed (P < 0.05). Conclusion Our results could supplement the information in the shoulder joint database with morphometric parameters and provide a reference for theoretical research on coracoid osteotomy, which may in turn help surgeons in the evaluation of coracoid process transfer.
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Affiliation(s)
- Yaofei Jia
- Department of Orthopedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, China.,Key Laboratory of Orthopedics of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730030, Gansu, China.,People's Hospital of Changwu County, Xianyang, 713600, Shaanxi, China
| | - Na He
- People's Hospital of Changwu County, Xianyang, 713600, Shaanxi, China
| | - Jiaxin Liu
- Department of Orthopedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, China.,Key Laboratory of Orthopedics of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Guangrui Zhang
- Department of Orthopedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, China.,Key Laboratory of Orthopedics of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Jianping Zhou
- Department of Orthopedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, China.,Key Laboratory of Orthopedics of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Ding Wu
- Department of Orthopedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, China.,Key Laboratory of Orthopedics of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Baomin Wei
- People's Hospital of Changwu County, Xianyang, 713600, Shaanxi, China
| | - Xiangdong Yun
- Department of Orthopedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, China. .,Key Laboratory of Orthopedics of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730030, Gansu, China.
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