A three-dimensional analysis of humeral head retroversion

Fraser Harrold, Carlos Wigderowitz

    Research output: Contribution to journalArticle

    19 Citations (Scopus)

    Abstract

    Introduction: The anatomic neck of the humerus is used as a reference for the osteotomy in shoulder arthroplasty. Resection along the anterior portion of the cartilage/metaphyseal border is assumed to remove a cap of a sphere that can accurately be replaced with a spherical prosthetic implant oriented precisely to the original articular surface. The aim of this study was to determine the variability in retroversion of the cartilage/metaphyseal interface in the axial plane. Methods: Surface topography data for 24 arms from deceased donors were collected by using a hand-held digitizer and a surface laser scanner. Data were combined into the same coordinate system and graphically presented. The humeral head was divided into 6 sections in the axial plane and the retroversion angle measured at each level with reference to the transepicondylar axis at the elbow. Results: The mean retroversion of the humeral head at the midpoint between the superior and inferior margins was 18.6°. The angle increased as the position of the measurement moved superiorly to 22.5°. In contrast, the retroversion angle reduced as the position of measurement moved more inferiorly to 14.3°. Discussion: The results suggest that the cartilage/metaphyseal interface is not circular encompassing a spherical cap of a sphere. Furthermore, there appears to be a clockwise torsion of the cartilage/metaphyseal interface about the transverse axis from its medial to lateral aspect. Conclusion: The cartilage/metaphyseal interface shows a degree of variability that makes it an unreliable landmark to perform an osteotomy when the anterior aspect of the interface is used.
    Original languageEnglish
    Pages (from-to)612-617
    Number of pages6
    JournalJournal of shoulder and elbow surgery
    Volume21
    Issue number5
    Early online date23 Jul 2011
    DOIs
    Publication statusPublished - 2012

    Keywords

    • osteotomy
    • TOTAL SHOULDER-REPLACEMENT
    • ORIENTATION
    • BICIPITAL GROOVE
    • PROSTHETIC DESIGN
    • Humerus
    • JOINT
    • PROXIMAL HUMERUS
    • modelling
    • geometry
    • version
    • NORMAL GLENOHUMERAL RELATIONSHIPS
    • ARTICULAR GEOMETRY
    • ARTHROPLASTY
    • SURGICAL TECHNIQUE
    • arthroplasty

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