Computational Analysis of Glenoid Bone Loss in Osteoarthritis Patients
Prey, Beau Joseph
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Changes in the glenoid are of clinical importance because they have been shown to be associated with humeral head subluxation and also inferior results following total shoulder arthroplasty. This wear can also decrease bone stock, creating further difficulty in implanting the glenoid component with good long term stability. Furthermore, Ting et al showed correction of increased retroversion can lead to perforation of the glenoid vault by the glenoid component pegs. It is proposed that perforation of the vault hinders the ability to achieve adequate pressurization of the cement, which in turn can result in component instability due to a lack of interdigitaton between the bone and cement. While this theory exists, the clinical consequences of this peg perforation have not clearly been established. One case control retrospective study of patients with and without peg perforation followed over 5 years demonstrated both decreased shoulder outcome scores and functional subscores in those with peg perforation. However, both this study and a similar prospective cohort study following patients with glenoid perforation showed no increase in radiologic signs of component loosening associated with peg perforation. The purpose of this study is to provide a novel characterization of the three dimensional morphology of the pathologic glenoid with various degrees of glenohumeral osteoarthritis. It is hoped that this characterization could potentially lead to better understanding of patterns of glenoid bone loss and identification of optimal areas for glenoid peg fixation. This study also aims to model these pathologic glenoids to predict component peg perforation. We hypothesize that there will be a unique pattern of bone loss along the posterior glenoid, and that increased bone loss will correlate with increased peg perforation.