• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.179-185
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• 2018

Background: We analyzed the angle between the glenoid anterior surface and glenoid axis, the range of the glenoid apex and the location of the glenoid apex for assistance during shoulder surgery. Methods: Sixty-two patients underwent a computed tomography of the shoulder with a proximal humerus fracture. In the range of the glenoid apex, the ratios of the distribution of triangles with a Constant anterior and posterior area of the glenoid were measured. The location of glenoid apex was confirmed as the percentage of the position with respect to the upper part of the glenoid with the center of the part, analyzed the angle between the glenoid anterior surface and glenoid axis was measured. Results: The angle between the glenoid anterior surface and glenoid axis was $19.80^{\circ}{\pm}3.88^{\circ}$. The location of the glenoid apex is $60.36%{\pm}9.31%$, with the upper end of the glenoid as the reference. The range of the glenoid apex was $21.16%{\pm}4.98%$. When the height of the glenoid becomes smaller, the range of the glenoid apex tends to become larger (p=0.001) and the range of the glenoid apex becomes wider (p=0.001) as the glenoid width narrows. Conclusions: We believe the anatomical measurements of the glenoid will be helpful for a more accurate insertion in glenoid component. It is thought that more accurate insertion is possible if we can set other anatomical measurements using computed tomography imaging of the glenoid which can develop into the study of other anatomical measurements.

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.24-28
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• 2019

Background: Glenoid baseplate location is important to good clinical outcomes of reverse total shoulder arthroplasty (RTSA). The glenoid vault is the determining factor for glenoid baseplate location, but, to date, there are no reports on the effect of central cage location within the glenoid vault on RTSA outcomes when using the $Exactech^{(R)}$ $Equinoxe^{(R)}$ Reverse System. The purpose of this study was to determine the appropriate cage location in relation to the glenoid vault and monitor for vault and/or cortex penetration by the cage. Methods: Data were retrospectively collected from the Samsung Medical Center (SMC) and Seoul National University Bundang Hospital (SNUBH). Patients who underwent RTSA between November 2016 and February 2018 were enrolled. Glenoid vault depth, central cage location within the vault were examined. Inferior glenoid rim-center distance, inferior glenoid rim-cage distance, and center-cage center distances were collected. Results: Twenty-two patients were enrolled. Three SNUBH patients had inappropriate central cage fixation (33.3%) versus 4 SMC patients (30.8%). All cage exposures were superior and posterior to the glenoid vault. Mean center-cage distance was 5.0 mm in the SNUBH group and 5.21 mm in the SMC group. Center-prosthesis distance was significantly longer in the inappropriate fixation group than in the appropriate fixation group (p<0.024). Conclusions: To ensure appropriate glenoid baseplate fixation within the glenoid vault, especially in a small glenoid, the surgeon should place the cage lower than usually targeted, and it should overhang the inferior glenoid rim.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.113-119
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• 2018

Background: This study was undertaken to evaluate the positional relationship between planes of the glenoid component (the scapular plane and the perpendicular plane to the glenoid) and its surrounding structures. Methods: Computed tomography (CT) images of both shoulders of 100 patients were evaluated using the 3-dimensional CT reconstruction program ($Aquarius^{(R)}$; TeraRecon). We determined the most lateral scapular bony structure of the scapular plane and measured the shortest distance between the anterolateral corner of the acromion and the scapular plane. The distance between the scapular plane and the midpoint of the line connecting the posterolateral corner of acromion and the anterior tip of the coracoid process (fulcrum axis) was also evaluated. The perpendicular plane was then adjusted to the glenoid and the same values were re-assessed. Results: The acromion was the most lateral scapular structure of scapular plane and perpendicular plane to the glenoid. The average distance from the anterolateral corner of the acromion to the scapular plane was $10.44{\pm}5.11mm$, and to the plane perpendicular to the glenoid was $9.55{\pm}5.13mm$. The midpoint of fulcrum axis was positioned towards the acromion and was measured at $3.90{\pm}3.21mm$ from the scapular plane and at $3.84{\pm}3.17mm$ from the perpendicular plane to the glenoid. Conclusions: Our data indicates that the relationship between the perpendicular plane to the glenoid plane and its surrounding structures is reliable and can be used as guidelines during glenoid component insertion (level of evidence: Level IV, case series, treatment study).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.337-345
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• 2011

Purpose: The purpose of this study was to define the relation of the degree of menton deviation and 3-D CT (computerized tomography) measurements of the glenoid fossa and the mandible, which are considered to have an influence on menton deviation. Methods: The CT images were obtained in 60 adults and these were transmitted to a computer and reconstructed using computer software. According to the degree of the menton deviation, which was measured on the posteroanterior cephalogram, the subjects were divided into the menton deviated group (30 adults) and the symmetry group (30 adults). A total of 11 measurements that might have an effect on menton deviation were determined and these were measured in the right and left sides using the function of 3-D measurement in the computer program. The 11 measurements consist of 6 measurements in the glenoid fossa (vertical position of the glenoid fossa and articular eminence, the sagittal position of the glenoid fossa and articular eminence, the depth of the glenoid fossa, and the anterior angle of the glenoid fossa), and 5 measurements in the mandible (ramus length, frontal ramal inclination, lateral ramal inclination, body length, body height). Results: The comparison of the differences between the menton deviated and symmetry groups and correlation analysis on the degree of menton deviation were carried out. The results of comparison of the right and the left difference between the menton deviated and symmetry groups showed that the vertical position and depth of the glenoid fossa were significantly increased in the menton deviated group. Conclusion: The results of the present study show that consideration of the shape and position of the glenoid fossa is necessary for making the diagnosis and administering proper treatment in facial asymmetry patients and especially growing patients.

• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.70-75
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• 2004

Purpose: To evaluate the results of arthroscopic repair of traumatic anterior shoulder instability with glenoid bone defect. Materials and Methods: Nineteen patients who had underwent arthroscopic repair for the shoulder with traumatic anterior instability and glenoid bone defect were retrospectively reviewed. Mean age was 24.6 years(range, 20 to 39) and mean follow-up was 23 months(range, 19 to 55). No glenoid bone defect was greater than 7mm in length and 20% of the glenoid. The results were evaluated according to stability, range of motion and function. Results: All patients obtained excellent-good results according to Rowe scoring system. Two patients(10.5%) had instability. The mean loss of external rotation was 15 degrees (range, 0 to 25). Functionally, 17 patients could participate in preinjured work or sports to the same level with or without mild discomfort. The remained 2 patients who had 25 degree loss of external rotation could not play sports. Conclusion: Though arthroscopic repair is a good treatment for traumatic anterior shoulder instability with small glenoid bone defect, it is possible to cause loss of external rotation

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.242-247
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• 2015

Background: The size of the baseplate used in reverse total shoulder arthroplasty (RTSA) tends to be larger than the average size of the glenoid in the Korean population. The mismatch between the sizes of the baseplate and the patient's glenoid may result in improper fixation of the glenoid baseplate. This in turn may lead to the premature loosening of the glenoid component. Thus, we evaluated the short-term results of using a 25-mm baseplate in RTSA. Methods: Seventeen patients with cuff tear arthropathy underwent RTSA with a 25-mm baseplate. The mean age of the patients was 70.1 years, and the mean follow-up period was 14.0 months. We evaluated clinical outcomes preoperatively and postoperatively: the range of shoulder motion, the American Shoulder and Elbow Surgeons (ASES) score, and the Korean Shoulder Society (KSS) score. Results: We found that the mean ASES score and KSS improved from 35.0 to 74.4 (p<0.001) and from 46.9 to 71.8 (p<0.001) with RTSA. The mean forward elevation and abduction, external rotation also improved from $78.6^{\circ}$ to $134.3^{\circ}$ (p<0.05) and from $66.6^{\circ}$ to $125.0^{\circ}$ (p<0.05), from $20.2^{\circ}$ to $28.4^{\circ}$ (p=0.43). Postoperative complications were seen in 12% of patients, but neither the loosening of the glenoid baseplate nor inferior scapular notching were observed. Conclusions: In sum, the results of using a 25-mm baseplate in RTSA were similar to those of previous reports. Even though the outcomes are those of a short-term follow-up, neither the loosening of the glenoid baseplate nor the scapular notching were observed.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.10a
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• pp.7-7
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• 2002

Historically, the decision to perform a hemiarthroplasty (HHR) versus a total shoulder arthroplasty (TSA) is based on the status of the glenoid and the status of the soft tissues (rotator cuff). In disease processes where the glenoid articular cartilage is relatively well preserved such as avascular necrosis and complex proximal humerus fractures, most orthopaedists recommend performing a HHR while preserving the native glenoid articular surface. At the other end of the spectrum, if the glenoid has excessive bone loss or is unreconstructible, a HHR is the preferred procedure. In patients who have deficient so(t-tissues (rotator cuff) such as rotator cuff tear arthropathy and, occasionally, rheumatoid arthritis, a HHR is the procedure of choice. The indications for HHR in osteoarthritis remain somewhat controversial. There is mounting evidence that performing a HHR for osteoarthritis is inferior to TSA. Recent developments, or 'third generation techniques and materials', in shoulder arthroplasty are expected to improve the longevity of TSA, particularly the glenoid component. In addition, newer designs of reverse-ball prostheses are entering the market with promising early results in patients with deficient rotator cuff mechanisms.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.49-53
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• 2000

There are few case reports of glenoid labral cysts related to the labral tear in the shoulder. Glenoid labral cyst is often overlooked in the diagnosis of shoulder pain. We are reporting a case of a glenoid labral cyst accompanying with anterior labral tear in the right shoulder of a 42 years old woman with the history of trauma. The cyst and anterior labral tear was successfully treated with arthroscopic excision and repair.

• Clinics in Shoulder and Elbow
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• v.17 no.4
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• pp.190-193
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• 2014

Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.

• The korean journal of orthodontics
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• v.17 no.1
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• pp.47-54
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• 1987

This study was designed to compare extreme variations in facial growth in order to examine the relationships between the glenoid fossa position and skeletal malocclusions. It was hypothesized that patients with large mandibular plane-sella nasion angles would have a more superior fossa position than patients with small mandibular plane-sella nasion angles. It was also hypothesized that patients with large ANB angles would have a more posterior fossa position than patients with small ANB angle. For this study, the data from lateral roentgenocephaloprams of 72 Females and 72 males aged from 10 to 18 years were used. The results were as follows 1. In the case of large ANB angle, glenoid fossa position was relatively posterior than that of small ANB angle in Female, but it was not significant in male. 2. In the case of large APDI, glenoid fossa position was relatively anterior in female, but it was not significant in male. 3. In the case of large SN-Go Gn angle, glenoid fossa position was relatively superior in both male and female. 4. In the case of large ODI, glenoid fossa position was relatively inferior in both male and female.