Hoel Letissier1, Jean Chaoui2, Michael J Bercik3, Pascal Boileau4, Dominique Le Nen5, Eric Stindel6, Gilles Walch7. 1. Service de chirurgie orthopédique et traumatologique, CHRU de la Cavale Blanche, 29200 Brest, France; Laboratoire de traitement de l'information médicale (LaTIM, UMR1101), bâtiment IBRBS, 22, avenue Camille-Desmoulins, 29200 Brest, France. Electronic address: letissierhoel@hotmail.com. 2. IMASCAP®, 29280 Plouzané, France. 3. Lancaster Orthopedic Group, 231 Granite Run Drive, Lancaster, PA 17601, USA. 4. Université de Nice Sophia-Antipolis, 06200 Nice, France. 5. Service de chirurgie orthopédique et traumatologique, CHRU de la Cavale Blanche, 29200 Brest, France. 6. Service de chirurgie orthopédique et traumatologique, CHRU de la Cavale Blanche, 29200 Brest, France; Laboratoire de traitement de l'information médicale (LaTIM, UMR1101), bâtiment IBRBS, 22, avenue Camille-Desmoulins, 29200 Brest, France. 7. Hôpital Privé J Mermoz Ramsay-GDS-Centre orthopédique Santy, 69008 Lyon, France.
Abstract
BACKGROUND: Recent studies have shown variations in glenoid bone density in asymmetric wear patterns but have yet to analyze non-arthritic or concentrically worn glenoids. QUESTIONS/PURPOSES: The purpose of this study is to characterize and compare subchondral glenoid bone densities in both non-arthritic and A1, A2, B1, B2 and B3 osteoarthritic glenoids, as well as to assess uniformity in symmetric and asymmetric erosion wear patterns. METHODS: In all, 150 computerized tomography (CT) scans containing equal numbers of non-arthritic (N), A1, A2, B1, B2 and B3 glenoids were segmented semi-automatically. Each reconstructed glenoid was divided first into anterior and posterior quadrants, and then further subdivided into four quadrants. Volumes of interest (VOI) were defined at depths of 0-2.5mm (Zone A), 2.5-5mm (Zone B) and 5-7.5mm (Zone C). Average bone densities were measured at each VOI depth and in each quadrant. RESULTS: Osteoarthritic glenoids had higher mean bone densities than N glenoids. Mean bone densities were uniform amongst all quadrants for N glenoids, but not for osteoarthritic glenoids. In A1 glenoids, the antero-superior quadrant was less dense in Zone C. A2 glenoids had increased bone density measured posteriorly in Zones B and C. In B1 and B2 glenoids, Zones B and C demonstrated increased bone densities of posterior quadrants compared to anterior quadrants. B3 glenoids presented similar results as A1 and A2 glenoids. Cystic changes were more pronounced in anterior quadrants of A2, B1, B2 and B3 glenoids. CONCLUSION: This study demonstrates that osteoarthritic glenoids have greater bone density than non-arthritic glenoids, independent of depth of interest. It also confirms that N glenoids have uniform erosion wear patterns and that B1 and B2 glenoids have irregular wear patterns. It is the first study to reveal that A1, A2 and B3 glenoids, though geometrically symmetrical, have irregular bony densities similar to B2 glenoids. These findings have clinical implications for reaming the glenoid and implant fixation. LEVEL OF EVIDENCE: Basic Science, Anatomy, Imaging.
BACKGROUND: Recent studies have shown variations in glenoid bone density in asymmetric wear patterns but have yet to analyze non-arthritic or concentrically worn glenoids. QUESTIONS/PURPOSES: The purpose of this study is to characterize and compare subchondral glenoid bone densities in both non-arthritic and A1, A2, B1, B2 and B3osteoarthritic glenoids, as well as to assess uniformity in symmetric and asymmetric erosion wear patterns. METHODS: In all, 150 computerized tomography (CT) scans containing equal numbers of non-arthritic (N), A1, A2, B1, B2 and B3 glenoids were segmented semi-automatically. Each reconstructed glenoid was divided first into anterior and posterior quadrants, and then further subdivided into four quadrants. Volumes of interest (VOI) were defined at depths of 0-2.5mm (Zone A), 2.5-5mm (Zone B) and 5-7.5mm (Zone C). Average bone densities were measured at each VOI depth and in each quadrant. RESULTS:Osteoarthritic glenoids had higher mean bone densities than N glenoids. Mean bone densities were uniform amongst all quadrants for N glenoids, but not for osteoarthritic glenoids. In A1 glenoids, the antero-superior quadrant was less dense in Zone C. A2 glenoids had increased bone density measured posteriorly in Zones B and C. In B1 and B2 glenoids, Zones B and C demonstrated increased bone densities of posterior quadrants compared to anterior quadrants. B3 glenoids presented similar results as A1 and A2 glenoids. Cystic changes were more pronounced in anterior quadrants of A2, B1, B2 and B3 glenoids. CONCLUSION: This study demonstrates that osteoarthritic glenoids have greater bone density than non-arthritic glenoids, independent of depth of interest. It also confirms that N glenoids have uniform erosion wear patterns and that B1 and B2 glenoids have irregular wear patterns. It is the first study to reveal that A1, A2 and B3 glenoids, though geometrically symmetrical, have irregular bony densities similar to B2 glenoids. These findings have clinical implications for reaming the glenoid and implant fixation. LEVEL OF EVIDENCE: Basic Science, Anatomy, Imaging.