J Shoulder Elbow Surg
Glenoid morphology rather than version predicts humeral subluxation: a different perspective on the glenoid in total shoulder arthroplastyHeinz R Hoenecke Jr 1, Lisa M Tibor, Darryl D D'Lima
Glenoid version did not correlate with humeral subluxation. The highest frequency of posterior subluxation was noted in biconcave glenoids.
Bone & Joint OpenVol. 3, No. 6
Shoulder & ElbowIs there a correlation between humeral osteoarthritis and glenoid morphology according to Walch?Philipp Vetter
Increased humeral osteophyte length correlated with a higher grade of glenoid morphology (A1-A2-B1-B2-B3) according to Walch (r = 0.672; p < 0.0001).
The criteria of humeral OL and HH morphology are associated with increasing glenoid retroversion, posterior humeral subluxation, and eccentric glenoid wear. Therefore, humeral radiological parameters might hint at the morphology on the glenoid side.
In a small sample size, I have found a corrrelation between posterior humeral subluxation and glenoid version
Anatomic vs Reverse Arthroplasty
degenerative tuberosity cysts;
glenoid version 13 degrees
80% posterior humeral subluxation
Lateralized offset humerus
Are these factors to consider?
Humeral retroversion is variable among individuals, and there are several measurement methods.
The mean humeral retroversion was 31.42° ± 12.10° using CT methods; the method using the bicipital groove center showed lower concordance, whereas the method using the posterior margin of the bicipital groove demonstrated higher concordance
Predicting humeral head retroversion preoperatively may be helpful although 10 degrees may not be significant
Multiple Myeloma scapular spine
80 year old male with failed rotator cuff surgery; High riding humeral head and poor function and motion; axillary view shows multiple myeloma lesion. What would you do?
70 year old female had a primary reverse shoulder 5 years ago. She sustained an accidental fall.
How would you manage this patient?
71 year old male had Tornier reverse total shoulder; 42 mm glenosphere; size 8 humeral stem (largest size); what's your opinion of the humeral stem size?
What would you do?
70 year old female sustained posterior shoulder dislocation 6 years ago. Underwent arthroscopic surgery to include cuff repair. 2 metallic sutures used; Benign humeral canal lesion; Now has severe pain and weakness; Forward flexion 90; ER 0; IR side of hip
Post operative xrays
Humeral bone quality
In elderly, osteoporotic females, a cemented humeral stem may be an option; xrays below are both 85 year old females
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