Abstract
Knowledge of the normal and pathological three-dimensional (3D) gleno-humeral relationship is imperative when planning and performing a total shoulder arthroplasty. Currently, two-dimensional (2D) parameters are used to describe this anatomy and despite the fact that these 2D measurements have a wide distribution in the normal population, they are commonly accepted. This broad distribution can be explained on one hand by anatomical factors and on the other hand, by positional errors. A 3D CT-scan reconstruction and evaluation can overcome this shortcoming and can be used to determine more accurately the surgical planes on the normal and pathological shoulder joint. There is, however, no consensus on which references should be used when studying this 3D relationship. This thesis describes the normal 3D gleno-humeral relationship and the best glenoid plane to use in surgery, based on 3D CT-scan. Furthermore, a glenoid aiming device that can be of surgical help in the reconstruction of the normal glenoid anatomy was developed based on these measurements.
Highlights
The shoulder joint is a very complex joint because of its great mobility
The bony alignment that is based on the biomechanical behavior of the shoulder joint, as described in this thesis fits perfectly with the comparison of a car with trailer driving in reverse mode as described in the introduction by Codman [1], were the glenoid plane is defined by the rear axis of the car and the centre of rotation with the trailer hook
This thesis studied the 3D gleno-humeral relationship and the bony anatomy of the glenoid based on 3D CT-scan reconstruction images with the patient in a standardized position
Summary
The shoulder joint is a very complex joint because of its great mobility. normal alignment of its structures is imperative for a good function as misalignment will result in malfunction. In a normal gleno-humeral joint there is an optimal positioning of the bony humeral head and glenoid with an optimal balance between these bony structures and the muscles. If the car wants to push back all the trailers in a correct manner, all components need to be in the exact position to each other. This is the same for the shoulder joint. In complex movements like arm raising, all bony components need to be in a correct alignment to each other The knowledge of this normal bony anatomy is imperative to understand its function and
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