Glenoid Research Articles

A modified human shoulder model considering the migration of the humeral head from the scapular glenoid fossa for the design of shoulder exoskeletons

The wearable upper limb exoskeletons designed using the traditional shoulder model have a serious issue related to joint axis misalignment with the human shoulder. The misalignment is primarily due to the limited degrees of freedom model assumed for the shoulder. The glenohumeral joint in the conventional upper limb model is considered a single spherical joint, which, when considering the human anatomy, neglects the humeral head translation from the glenoid fossa of the scapula. This shoulder model cannot be used for designing the wearable upper limb exoskeletons, which can damage the shoulder joint due to interactive forces generated from the human-exoskeleton joint misalignment. This paper presents a modified, anatomically similar, human upper limb model where the single spherical joint of the glenohumeral joint is modified into two spherical joints connected by a prismatic joint. The kinematic and dynamic model of the proposed shoulder model is explained in detail. The elbow reachable space for this model has been calculated and compared with that of the existing models, and it is found to be closer to the actual workspace. The proposed model is simulated with a conventional exoskeleton attachment to show the effect of misalignment during humeral head translation and the benefits of using the proposed model in the design of the shoulder exoskeleton. An exoskeleton test bench that uses the modified shoulder model is also presented.

Diagnostic imaging findings in lame Warmblood horses with bone injuries of the medial proximal phalanx glenoid cavity.

This retrospective study aims to describe baseline and follow-up imaging findings in subchondral and trabecular bone damage occurring outside of the sagittal groove in the proximal phalanx (P1) glenoid in a case series of lame Warmblood horses. Thirteen lame horses (16 forelimbs) with standing magnetic resonance imaging (sMRI) evidence of nonsagittal groove glenoid subchondral and trabecular bone injury of P1 as the main lesion were included. All injuries were located at the medial aspect of the P1 glenoid. At sMRI, changes included subchondral bone plate thickening and trabecular sclerosis, bone marrow edema-like signal, subchondral bone resorption (11/16), and new bone production (8/16). Subchondral bone resorption in the transverse plane was linear (8/11), round (2/11), or ill-defined (1/11). Sclerosis, bone resorption, and new bone production were seen radiographically in 10, 4, and 5 limbs, respectively. All limbs had concurrent metacarpal condyle sMRI imaging abnormalities, osteophytosis, and joint effusion. Follow-up sMRIs were obtained in 8 of 16 limbs, five of which showing progression of the resorptive lesion. One horse encountered a comminuted fracture of the affected P1 18 months after the follow-up sMRI examination. The imaging appearance of the medial glenoid bone injuries of P1 in this case series is consistent with chronic bone overload. The linear configuration of bone resorption seen in eight lesions suggests short, incomplete stress fractures, which is supported by the ultimate catastrophic fracture occurring in one case.

Arthroscopic Minced Cartilage Implantation for Chondral Lesion at the Glenoid in the Shoulder: Technical Note

Joint cartilage damage is a common condition, and various approaches exist to address these defects. Whenever conservative treatments have been exhausted or are inadequate, surgery should be taken into consideration. However, it is essential to consider the size of the damage as well as the subchondral bone involvement. As joint replacement is not an appropriate treatment for young people, a joint-preserving technique should be preferred. One option is minced cartilage implantation. This surgical procedure is appropriate for defects of around 2 cm2. Studies demonstrated exceptional short-term and midterm outcomes in the knee and hip. This description of technique focuses on the implementation of AutoCart augmentation on the glenoid. The purpose of this note is to gain technical evidence of an all-arthroscopic cartilage implantation technique performed within the glenoid cavity.

Morphometric Analysis of Glenopolar Angle of the Scapula in Indian Population.

The glenopolar angle (GPA),usually ranges from 30° to 45°. GPA measures the tilt of the plane of the glenoid cavity in relation tothe axis of the body of the scapula passing from the superior pole of the glenoid cavity to the inferior angle of the scapula.It is essential to assess the results of surgeries for dislocated shoulders. Worse long-term outcomes can arise from glenoid misalignment in scapular neck fractures. When evaluating prognosis and planning therapy for shoulder injuries including scapular fractures, GPA assessment is essential. Still, there is a dearth of data on the normal range of GPA and its contributing elements, which calls for more study. The purpose of this study is to determine typical GPA values by utilizing radiographs and a sizable sample of scapular bone specimens. In this study, the GPA was assessed in 50 chest radiographs of anteroposterior (AP) view and Neer's view of individuals as well as 100 dried scapulae of any gender. The mean GPA obtained using the various methods was then statistically compared. All scapulae had an average GPA of 42.6°. Twenty-ninescapulae had GPA observations higher than 45°, with an average of 47.2°. Twenty-seven scapulae had GPA measurements below 40°, averaging 37.3°.Right-sided 62 scapulae with an average GPA of 43.1°were present. Thirty-eight of left-side scapulae had a GPA of 41.7° on average. It was determined that the 1.6° mean difference in GPA between the two groups was not statistically significant. The Kolmogorov-Smirnov test verified that the GPA data had a normal distribution. The homogeneity of variances across various measuring techniques was confirmed using Levene's test. The average GPA measured using the dry scapula approach was 42.6°, the average GPA measured using the AP view was 39.8°, and the average GPA measured using the Neer I view was 42.3°. The GPA means from these three approaches differed considerably (p=0.0014) according to a one-way Analysis of Variance (ANOVA). Fisher's least significant difference post hoc testing showed thatthe scapular bone specimens and the Neer I view revealed significantly higher GPA values than AP shoulder radiographs.The GPA values obtained from the osteological group and the Neer I perspective had a mean difference of 0.21°, which was practically identical and suggested that there was no statistically significant difference between these approaches. In order to diagnose and treat a variety of shoulder joint diseases, this study estimates the normal values of scapular GPA. Furthermore, it offers support for improved implant design in the context of Indian shoulder joint replacement and repair.Using every measurement technique, the GPA values on the right and left sides did not differ significantly.GPA results from various measuring methods varied significantly, which emphasizes the significance of methodological consistency in clinical and research settings.

Volumetric differences in the temporomandibular joint in patients with condylar hyperplasia in active and passive state, SPECT/CT study.

Condylar hyperplasia (CH) is a progressive and deforming disease that modifies anatomy of the temporomandibular joint (TMJ) structures. This study aims to correlate the metabolic bone activity of the condyle measured by SPECT with the volumetry anatomic information from the condyle, fossa and joint space provided by CT images, in patients with CH in active and inactive forms. A cross-sectional comparative study was performed with a set of 116 images from healthy and diagnosed CH patients to compare volumetric measures of the TMJ. Images were acquired through a bone tissue mask using a three-dimensional DICOM reconstruction for SPECT/CT and CBCT images and the Threshold option for segmentation with standardized values for each tissue on the HU scale. there are differences (p<0.01), with greater condylar volume on the affected side in patients with active CH compared to passive CH. The volume of the glenoid cavity shows no differences in either form of CH (p>0.05), however, there were differences for the volume of the joint space on the affected right side of hemimandibular elongation (HE) in the active form. The volume of the mandibular condyle on the affected side in CH cases were larger in HE cases in active and inactive form (p<0.01) compared to healthy patients. Similar results were presented for the glenoid cavity and joint space. Volumetric anatomical evaluation of TMJ structures, as well as information on condylar metabolic activity, can be obtained from SPECT/CT. The study shows a greater condylar volume on the affected side of the CH compared to the contralateral side, but there are more significant differences in the active than in the inactive form.

Utilizing Diagnostic Musculoskeletal Ultrasound for Assessment of the Infraspinatus Muscle and Tendon: Implications for Rehabilitation Professionals

The rotator cuff, comprising the subscapularis, supraspinatus, infraspinatus, and teres minor muscles, plays a crucial role in stabilizing the glenohumeral joint by securing the head of the humerus within the glenoid cavity of the scapula. The tendinous insertions of these muscles generate tension within the capsule, enhancing joint stability during muscular activity. The rotator cuff is susceptible to damage from disease, injury, or trauma, which can result in tears or ruptures of one or more tendons. The evaluation of the infraspinatus muscle and tendon is vital for diagnosing and managing various shoulder pathologies. Accurate imaging to determine the specific muscle involvement and injury severity significantly impacts treatment decisions. Diagnostic musculoskeletal ultrasound (MSK-US) has emerged as a valuable tool for assessing the infraspinatus muscle and tendon, offering real-time, dynamic assessment capabilities essential for precise diagnosis and effective rehabilitation planning. This article reviews the utility and advantages of MSK-US in evaluating the infraspinatus muscle and tendon, emphasizing technique specifics, diagnostic accuracy, and comparative efficacy against other imaging modalities. It details a systematic approach to the ultrasound examination technique for the infraspinatus, including patient positioning and identification of common pathologies such as tears, tendinopathy, and calcifications. With recent advancements in transducer strength, image resolution, and operator training, ultrasound serves as an excellent alternative imaging modality for diagnosing rotator cuff tears. This article aims to equip rehabilitation professionals with a comprehensive understanding of MSK-US as a diagnostic tool for the infraspinatus, promoting more precise diagnosis, treatment planning and improved patient outcomes.

Automatic quantification of scapular and glenoid morphology from CT scans using deep learning

ObjectivesTo develop and validate an open-source deep learning model for automatically quantifying scapular and glenoid morphology using CT images of normal subjects and patients with glenohumeral osteoarthritis. Materials and MethodsFirst, we used deep learning to segment the scapula from CT images and then to identify the location of 13 landmarks on the scapula, 9 of them to establish a coordinate system unaffected by osteoarthritis-related changes, and the remaining 4 landmarks on the glenoid cavity to determine the glenoid size and orientation in this scapular coordinate system. The glenoid version, glenoid inclination, critical shoulder angle, glenopolar angle, glenoid height, and glenoid width were subsequently measured in this coordinate system. A 5-fold cross-validation was performed to evaluate the performance of this approach on 60 normal/non-osteoarthritic and 56 pathological/osteoarthritic scapulae. ResultsThe Dice similarity coefficient between manual and automatic scapular segmentations exceeded 0.97 in both normal and pathological cases. The average error in automatic scapular and glenoid landmark positioning ranged between 1 and 2.5 mm and was comparable between the automatic method and human raters. The automatic method provided acceptable estimates of glenoid version (R2 = 0.95), glenoid inclination (R2 = 0.93), critical shoulder angle (R2 = 0.95), glenopolar angle (R2 = 0.90), glenoid height (R2 = 0.88) and width (R2 = 0.94). However, a significant difference was found for glenoid inclination between manual and automatic measurements (p < 0.001). ConclusionsThis open-source deep learning model enables the automatic quantification of scapular and glenoid morphology from CT scans of patients with glenohumeral osteoarthritis, with sufficient accuracy for clinical use.

Evaluation of temporomandibular joint morphology and morphometry in male osteoporotic patients using advanced imaging and biochemical markers: A cross-sectional study.

Osteoporosis is a condition with reduced bone mass and disrupted architecture. Osteoporosis affects the Temporomandibular disorders (TMD) by changing bone density and quality. This study aims to determine the nature and extent of temporomandibular joint (TMJ) involvement in osteoporotic patients by correlating TMJ morphological changes detected by CBCT with systemic bone health indicated by BMD T-scores from DEXA and analyzing BTMs in serum and saliva. This study was a cross-sectional study conducted from May 2021 to December 2022. It involved 50 participants divided into two groups (N=25). One group was healthy male, while the other group had osteoporosis male. Saliva and blood samples were collected, and diagnostic imaging was conducted. The prevalence of various bone changes in the condyle was examined using CBCT. Erosion was found to be the most common, followed by Flattening, Osteophyte, and Subchondral cysts. The study group had significantly higher rates of smooth condyle, erosive lesions, and osteophytes compared to the control group. Pseudocyst decreased on the right side but increased on the left side. Pain on the right side increased more in the study group, and the T score for osteoporosis was higher in the study group. Joint spaces, condyle diameter, and glenoid cavity measurements differed significantly between sick and healthy people, as shown by CBCT (P≤0.001). Only the ALP parameter in the serum showed a significant increase in the study group compared to the control group. Saliva analysis revealed higher levels of calcium, osteocalcin, and ALP in the case group compared to the control group. The results of this study showed that CBCT as a specialized technique in imaging by providing detailed images can be used to evaluate osteoporosis and be used as an accurate diagnostic tool.

From Data to Design: Constructing Scapula and Hip Bone Through Online Datasets, Open-Source Software and 3D Printers.

Introduction Human skeletons and bones are essential for medical and allied sciences students. Nowadays, it is becoming challenging to procure bone legally, resulting in medical students' inadequacy of bone. Plaster-of-Paris or resin bone models sold on the market are less detailed than real bones. Aims and objectives This study aims to create a three-dimensional (3D)-printed human bone model with free, open-source software and fused deposition modelling (FDM) 3D printers, compare its accuracy with the original bones and validate it with a textbook description. Methods Scapula and hip bone models were produced using open-source software 3D Slicer from computed tomography (CT) data from the "New Mexico Decedent Image Database". After automated segmentation, bones were edited manually with tools in a 3D Slicer(https://www.slicer.org/) and Meshmixer software(Autodesk Inc., San Rafael, California, United States) and 3D bone models were printed using polylactic (PLA) filament. Results and discussions 3Ddigital models of both bones were successfully created with the maximum possible accuracy with an FDM 3D printer. A 3D digital replica of the scapula obtained after segmentation retained most anatomical features except for the glenoid cavity, as the head of the humerus obscured the glenoid cavity. The 3D digital skeleton of the hip bone retained all anatomical features except articulating surfaces, such as the acetabulum and auricular surface ilium, which were obscured by the head of the femur and sacrum. A few morphological features of both bones differed from the original dry bone, and a few finer details were unclear in the iliac fossa and ischium. After manual editing and post-processing, the final physical model obtained has all the features. Conclusions We conclude that it is possible to produce anatomically accurate models with the greatest possible resemblance and accuracy to the original bones using free and open-source data with an FDM 3D printer.

The Role of Arthroscopy in Contemporary Glenoid Fossa Fracture Fixation.

Glenoid fossa fractures are rare injuries accounting for 10 to 29% of all intra-articular scapula fractures. They are usually the result of high-energy trauma, and concomitant injuries are not uncommon. Patients with glenoid fractures are admitted with shoulder pain and restricted range of motion. Although shoulder plain radiographs could establish the diagnosis, a computed tomography scan is necessary to adequately define the fracture pattern and characteristics. The most commonly used classification system is that of Ideberg (modified by Goss), which includes five glenoid fossa fracture types according to the location, extension, and complexity of the lesion. Articular surface displacement and step-off are the most important factors that should be taken under consideration when deciding for conservative or surgical management. Operative treatment includes open reduction and internal fixation through a posterior or anterior approach depending on fracture morphology and displacement. However, open surgical techniques are related to extensive soft-tissue disruption, risk of neurovascular injury, and inadequate exposure of the entire glenoid cavity. Introduction of arthroscopy could facilitate better visualization of the glenoid articular surface and improved fracture reduction. However, it is a technically demanding procedure with many challenges and pitfalls. The aim of this review is to summarize the current evidence regarding the treatment of glenoid fossa fractures and present the beneficial effect of arthroscopy in improving the quality of fracture fixation and overall functional outcomes.

Specific complications associated with shoulder joint replacement

Complications such as scapular notching or artery, nerve and deltoid muscle damage can outweigh the benefits of shoulder joint replacement and result in poor functional outcomes. Reverse shoulder joint replacement may cause traction deformation of the brachial plexus and axillary vessels due to constructive medialistion and distalisation of the shoulder component. Delayed surgery after a fracture can lead to bleeding from damage to the axillary artery wall during the release of scarred soft tissues. Although most neurological complications after reverse arthroplasty (RA) are reversible, some persist, particularly damage to the axillary nerve. These complications can occur due to various reasons such as the use of acute retractors, glenoidal cavity release and humerus traction with further distalisation. Fixing the scapular component with screws can damage the supra-scapular nerve. Deltoid muscle dysfunction remains a serious complication due to axillary nerve damage or muscle fibre ruptures. Notching syndrome occurs when the shoulder component of the endoprosthesis collides with the scapula. Shoulder component dislocation, often caused by insufficient soft tissue tension due to implant misplacement, is not uncommon.This study was necessitated by the significance of these complications, their varied causes, the relative rarity of reverse arthroplasty, previous shoulder trauma altering anatomy, poor functional outcomes, and diverse problem-solving approaches.

Analysis of the stress-strain state of a three-dimensional model a shoulder hemiarthroplasty after changing the greater tubercle position on the shoulder

Background. The greater tubercle position change in shoulder hemiarthroplasty is of great importance for the shoulder joint contact surfaces’ stress-strain state (SТS). One of the important conditions for restoring a full range of motion in the shoulder joint after hemiarthroplasty and a longer service life of the endoprosthesis is the anatomical location of the greater tubercle. The purpose was to develop a three-dimensional model and study the STS of elements of the shoulder joint and implants of a hemiarthroplasty after changing the greater tubercle position on the shoulder. Materials and methods. The SolidWorks software package was used in order to construct a simulated 3D model of the shoulder joint, taking anatomical and anthropometric data into conside­ration to make the model as close to the real shoulder joint as possible. The ANSYS software package was used to calculate the shoulder joint models of the total load vector at different positions of the total load vector, depending on the greater tubercle of the humerus position. Results. The analysis of the shoulder joint mo­del elements’ STS with different greater tuberosity positioning and a shoulder abduction angle of 60° showed that the maximum increase in stress values is observed on the glenoid cavity subchondral bone when the greater tubercle of the humerus is transposed by 1 cm anterior — in 3.4 times, σmax up to 4.02 MPa. Moving the big tubercle by 1 cm distally is an optimal position in which the subchondral bone of the glenoid cavity undergoes minimum stress and deformation forces. Conclusions. The change in pressure on the contact surfaces is significant when changing the position of the greater tuberosity, which will undoubtedly affect the volume and range of motion in the postoperative period. Taking into account the data of the stress values on the contact surfaces obtained from our simula­ted 3D computer model of the shoulder joint allows improving the quality of preoperative planning and improving shoulder function and possible complications in the postoperative period.

EVALUATION OF THE CONDYLAR POSITION IN RELATION TO THE DIFFERENT MALOCCLUSIONS OF A STUDENT POPULATION

Studying the position of the condyle in the glenoid cavity is an important aspect of achieving the diagnosis and the treatment plan in dentistry. The posterior position of the condyle in the glenoid cavity is not a completely reliable predictor of the lack or appearance of disc displacement, although they are related (1). The TMJ is a small joint with a complex morphology surrounded by bony tissues that create a superimposition of images, especially in the petrous region of the temporal bone, the mastoid process and the articular eminence (1). Studies on the ideal position of the condyles have shown that the healthiest condyle-fossa relationship in which the condyle is centered anteriorly in the mandibular fossa. The following research aims to evaluate the condylar position in relation to different malocclusions of thirty-two students of the Faculty of Dentistry of the University of Cuenca.The research has a quantitative approach, carried out by means of numerical analysis. The population used was thirty-two students from the Faculty of Odontology in the University of Cuenca, aged between 21 and 29 years, who underwent cone beam computed tomography. The research was carried out as a descriptive retrospective sample and provides systematic information. The research used is of a primary source, using CBCT scans obtained from an image bank at the CERIOM Radiology Centre in the city of Cuenca, and the tomographic examination will be imported in DICOM format into the RadiAnt DICOM Viewer software (64-bit).

Volumetric differences in temporomandibular joint components in patients with facial asymmetry: A 3D tomographic segmentation study

PurposeTo determine if there are differences in condylar volume, glenoid cavity and joint space between patients diagnosed with facial asymmetry (FA), between affected and contralateral sides and with respect to subjects without FA. MethodsCross-sectional, retrospective study comparing CT/CBCT images from patients with FA diagnosis referred to a private clinic, versus a control group, age and sex matched, of patients requiring orthodontic treatment without FA. The 3D Slicer software was used for the analysis. Bivariate analysis was performed to compare qualitative variables using Chi-square or Fisher tests, and for normal distribution quantitative variables, the t-student test was used. The level of significance was p < 0.05. ResultsThe FA group (n = 138) included: Hemimandibular Elongation (HE) (n = 64), Hemimandibular Hyperplasia (HH) (n = 12), Hybrid Form (HF) (n = 20), Asymmetric Mandibular Prognathism (AMP) (n = 25), Glenoid Cavity Asymmetry (GCA) (n = 9) and Functional Laterognathism (FL) (n = 8). The control group (n = 20) had no FA and no signs or symptoms of temporomandibular dysfunction. The right condylar and glenoid cavity volumes were significantly larger in FA cases. The volumes of the right and left joint space had significant differences only in HE patients. ConclusionCondylar volumes are higher in almost all FA subgroups compared to matched controls. The glenoid cavity volume is larger in FA patients, except for the GCA right and FL left sides. Regarding articular spaces, HE was the only entity with less volume on the contralateral side. The evaluation of structural volume by 3D-CT images helps to diagnose and differentiate FA subgroups.

Morphometric analysis of cavitas glenoidalis with multidedector CT

The glenoid cavity is a sliced egg-shaped joint surface located on the lateral margin of the scapula to form the shoulder joint. Recognition of variations in shape and dimensions of the glenoid cavity is important for a better comprehension of joint-associated diseases, especially in total shoulder arthroplasty procedures. The aim of this study was to perform morphometric measurements on the glenoid cavity. Glenoid cavities of 391 individuals (197 males [50.4%], 194 females [49.6%]) were reviewed by using Multi-detector Computed Tomography. The maximum length and maximum width of glenoid cavities, as well as the width, depth and circumference at the notch level were measured, and the index value was calculated. The glenoid cavity shapes were typed as pear, inverted comma and oval type. Furthermore, the metric values that provide the best differentiation between genders were identified through ROC analysis. The pear glenoid cavity type was detected in 53.2%, inverted comma type was detected in 28.4%, and oval type was detected in 18.4% of cases. In all of our morphometric measurements, male values were higher than female values, and there was significant difference between them. Results of ROC analysis revealed significant measurements for the maximum length and maximum width measurements of the glenoid for gender determination. Morphometric information of the glenoid cavity can be useful in order to increase clinical success in case of Bankart lesion, rotator cuff disease, and osteochondral defect. Recognition of different shapes and dimensions of the glenoid cavity is essential for the design of the glenoid component, especially for total shoulder arthroplasty procedure. We believe that the data obtained in our study would be useful for prosthesis designers and orthopaedic surgeons.

Anatomical Study of an Adult Human Temporomandibular Joint in Iraq

Temporomandibular articulation is the highest feature that outlines the class of the mammalian and divorces mammals from further vertebra, it allows normal parting and departing of the jawbone and is needed for purposes such as mastication and speaking. Com ponents of this synovial joint between the condyle process of mandible and glenoid cavity of the temporal bone has been studied anatomically and histologically in 25 autopsies of adult males and female were examined at different Iraqi cities. Descriptions of TMJ related structures skin, parotid gland with its traversed facial nerve, all are related laterally the capsule of the joint, the fibrous connective tissue sac and lines with synovial membrane, containing synovial fluid, capsule is supported anteriorly by the fibers of the sphenomandibular ligaments and to the facial fibers of the masseter muscle .Also present study descri be rectangular masseter muscle with its dimensions (70±12mm) x (50 ±14) mm; contemporary no readings were recorded. In addition dimensions of the ovoid condyle process were 15 to 20 mm from side to side and 8to 10 mm from front to back Current study mentioned dimensions of the mandibular foss a which has been delimited by the attachment of joint capsule antereoposterior dimension was range from 24 – 38 mm and its lateral dimension from side to side was ranging from 19- 33mm, these differences between the condyle process and glenoid fossa inform us the free movement of the small condyle process within the fossa were it glide anteriorly furing protraction of the mandible and then its retraction. Measurements of different bones at different sex depict that the thickest trabeculae by its mean &amp; standard deviation is founded in male in condyle process, 13.03+1.54, though the thinnest trabeculae is founded in female within the mandibular fossa of the temporal bone, 11.23 +0.90. Despite the fact for recorded algebraic data of the gaps, spaces were occupied by the tr abeculae displays that the widest gaps in dimension were seen in female mandibular fossa, 36.20 +0.71. While the narrowest spaces were seen between the trabeculae of condyle process bone of the mandible in male, 23.25+0.93. From current study anatomical features are grossly in agree with other anatomist descriptions, but dimensions of fossa and condyle are greater than other studies.

Investigation of Morphological and Biomechanical Properties of the Scapula for Shoulder Joint.

The glenopolar angle is a helpful criterion for recommending operative treatment. This study aims to determine the morphometric features of the scapula and provide essential information that supplies scapular biomechanics to produce a formula. The study was carried out on 34 dry scapulae in the laboratory of the Anatomy Department of the Faculty of Medicine, Bursa Uludag University. We used calipers for the linear measurements and the ImageJ program for the area and angle parameters. A total of 23 parameters were evaluated in the study. Statistical analyzes were performed using SPSS 22.0 software. According to the results of the correlation analysis, the highest correlation value of (R=0.957) was found to be the distance between the superior angle (angulus superior)-top of the glenoid plane and the inferior angle (angulus inferior)-the top of the glenoid plane. To estimate the glenopolar angle, we applied linear regression analysis and developed the following formula: Glenopolar angle =115.589 - (6.401 x the distance between the coracoid process and the top of the glenoid cavity) - (0.368 x angle between the glenoid plane and the lateral edge of the scapula extending towards the endpoint of the glenoid plane) (Adjusted R2=0.667). Glenopolar angle can provide information about the fracture risk of the glenoid cavity and allows orthopedic surgeons to make quick decisions about the risk in the region. We believe that the study will provide a different perspective on designing different products in industrial designs for shoulder joints, especially in implantations.

Morphometric analysis of glenoid cavity in adult human scapulae and its clinical importance

Background: The glenoid cavity of scapula is quite small, which allows space for only limited fixation devices. Appropriate fixation of the glenoid component of shoulder is of key importance in total shoulder arthroplasty to prevent loosening, which is a common indication of revision surgery. Orthopedic surgeons and prosthetic designers must have a thorough understanding of the glenoid’s dimensions and shape, in order to create the finest feasible prosthesis. Aims and objectives: To determine the glenoid cavity index (GCI) and the form of the glenoid cavity, as well as the supero-inferior diameter, shortest antero-posterior diameter, and longest antero-posterior diameter. Materials and methods: The study was conducted on 50 dry unpaired adult human scapulae of North Indian population obtained from GMC, Srinagar. All the important morphometric parameters were studied using a vernier calliper. Result: Supero-inferior diameter, shortest antero-posterior diameter, and longest antero-posterior diameter were found to have respective mean values of 35.06 mm, 15.8074 mm, and 23.3814 mm. Glenoid cavity index had a mean value of 66.68. 42% of the glenoid cavities had an inverted comma shape, 36% had a pear shape, and 22% had an oval shape. Conclusion: The results showed that mean supero-inferior diameter of glenoid is about 35mm while the average prosthesis for shoulder arthroplasty in the market starts from 40mm. This suggests that while developing and fitting glenoid components for total shoulder arthroplasty in the North Indian population, it may be necessary to take into account the smaller dimensions of the glenoid cavities.

Evaluation of Anthropometric Scapula Indices in CT Scan Images for Gender Distinction in the Besat NAHAJA Hospital

Background: In forensic medicine, several bones are used to determine gender. The most important and widely used are the skull and pelvis. But in some cases, the mentioned bones may not be available, and other bones, such as the scapula bone, should be used. Objectives: This study aimed to investigate and locate the anthropometric indices of scapula bone in the Iranian population to determine gender. Methods: In this project, a study was performed on a chest scan of 259 Iranians referred to Besat NAHAJA Hospital in 2016. Pack software was used to measure the scapula's indices. The obtained data, including age, gender, and different scapula sizes of max width of glenoid (MWG), max length of glenoid (MLG), max width of scapula (MWS), and max length of scapula (MLS), were analyzed using appropriate statistical tests. Assessment of differential ability, sensitivity, and specificity of scapula anthropometric indices was used in determining gender. Results: Of 259 participants in this study, 133 (51.4%) were female, and 126 (48.6%) were male. Generally, the mean index of MWG, MLG, MWS, and MLS was higher in men than women in the studied population. The results of this study showed there is a significant difference among scapula features in men and women (P &lt; 0.05). The highest accuracy in determining gender was assigned to MLS, with 88.9%, and the lowest was assigned to MLG, with 66.3%. Conclusions: Our study showed that measured anthropometric indices, including length and width of scapula bone and glenoid cavity, will help to predict gender and also can be used as an accurate and practical tool in gender determination.

Effect of Glenohumeral Joint Bone Morphology on Anterior Shoulder Instability: A Case-Control Study.

Glenohumeral joint compatibility and bone morphology are among the most critical factors in shoulder stabilization. Our study investigated the effect of the bone morphological structure of the shoulder joint on anterior shoulder dislocation. In our study, people with a history of shoulder dislocation were selected as the patient group. In the control group, patients with shoulder MRIs for any reason and no history of shoulder dislocation were included. Those who have a fracture around the shoulder, a congenital deformity in the shoulder region, arthrosis of the shoulder, those whose MRI images cannot be measured, those with Hill-Sachs lesion, connective tissue diseases (such as Ehler Danlos), who are unsure of their diagnosis, or who have incomplete and incorrect suspicious information in their patient file have been excluded. In our retrospective case-control study, glenoid width, glenoid height, glenoid's height-to-width ratio, glenoid's depth, glenoid's version, glenoid's inclination, humerus radius of curvature, glenoid radius of curvature, and bony shoulder stability ratio were measured on MRI images of the patients. The sample size for each group was determined using a power analysis method. The intra-class coefficient (ICC) assessed interobserver and intraobserver reliability. A total of 80 patients, 40 each in the control and patient groups, were included in the study. Glenoid width was measured as 24.27 ± 1.58 in the patient group, 25.61 ± 1.72 in the control group; glenoid height was as measured 36.49 ± 2.26 in the patient group, 36.74 ± 1.99 in the control group; height-to-width ratio was measured as 1.5 ± 0.08 in the patient group, 1.43 ± 0.05 in the control group; glenoid version was as measured -0.53 ± 1.17 in the patient group, -1.44 ± 1.1 in the control group; glenoid inclination was measured as 1.44 ± 3.93 patient group, 2.64 ± 3.81 in the control group; glenoid depth was measured as 1.69 ± 0.41 in the patient group, 2.12 ± 0.53 in the control group; humerus radius of curvature was measured as 29.70 ± 6.76 in the patient group, 24.98 ± 3.22 in the control group; glenoid axial radius of curvature was measured as 61.8 ± 13.52 in the patient group, 52.53 ± 15.69 in the control group; glenoid coronal radius of curvature was measured as 43.01 ± 7.47 in the patient group, 37.74 ± 6.89 in the control group; the bony shoulder stability ratio was measured as 0.35 ± 0.06 in the patient group and 0.44 ± 0.06 in the control group. In the statistical evaluation, the glenoid width (p < 0.001), the glenoid height/width ratio (p < 0.001), the glenoid version (p < 0.001), the depth of the glenoid cavity (p < 0.001), and the radius of curvature measurements of the humeral head (p < 0.001) and the glenoid (axial, p < 0.007; coronal, p < 0.001) were found to be significantly different. Glenoid height and inclination were similar in both groups. The detection of bone morphological features that constitute risk factors for shoulder dislocations plays an important role in preventing shoulder dislocations. In this way, it provides essential data on personalized rehabilitation programs and treatment selection for recurrent dislocations.