Prearthroplasty glenohumeral pathoanatomy and its relationship to patient's sex, age, diagnosis, and self-assessed shoulder comfort and function

Abstract

There is great current interest in characterizing the prearthroplasty glenohumeral pathoanatomy because of its role in guiding surgical technique and its possible effects on arthroplasty outcome. We examined 544 patients within 6 weeks before arthroplasty with the goals of characterizing the following: demographic and radiographic characteristics; relationships of the radiographic pathoanatomy to the patient's age, sex, and diagnosis; inter-relationships among glenoid type, glenoid version, and amount of decentering of the humeral head on the glenoid; and relationships of the pathoanatomy to the patient's self-assessed comfort and function. Male patients had a higher frequency of B2 glenoids and a lower frequency of A2 glenoids. The arthritic shoulders of men were more retroverted and had greater amounts of posterior decentering. Patients with types A1 and C glenoids were younger than those with other glenoid types. Shoulders with osteoarthritis were more likely to be type B2 and to be retroverted. Types B2 and C had the greatest degree of retroversion, whereas types B1 and B2 had the greatest amounts of posterior decentering. Shoulders with glenoid types B1 and B2 and those with more decentering did not have worse self-assessed shoulder comfort and function. Glenohumeral pathoanatomy was found to have previously unreported relationships to the patient's sex, age, and diagnosis. Contrary to what might have been expected, more advanced glenohumeral pathoanatomy(ie, type B glenoids, greater retroversion, greater decentering) was not associated with worse self-assessed shoulder comfort and function.