Radiologic and anatomical evaluation of scapular inclination, glenoid version, and scapulothoracic angle in healthy adult subjects
Öz
Purpose: The aim of this study is to determine the normal reference values for natural glenoid version, scapulothoracic angle, and scapular inclination angle in a healthy population, and to assess whether these parameters vary according to age and gender.
Materials and Methods: This study was conducted on 120 healthy adult subjects (58 females, 62 males) aged 21 to 75 years, using Computed Tomography (CT). The participants were divided into two primary groups based on gender (female and male), and further categorized into six age-based groups. Five parameters were evaluated in total. The glenoid version was measured at three levels: middle (GVM), below (GVB), and above (GVA) the glenoid.
Results: The mean ages of the female and male participants were 51.54 ± 20.16 years and 49.60 ± 18.82 years, respectively. The GVA, GVM, GVB, SIA, and STA were found as 5.53°±8.01°, -0.02°±5.08°, 1.37°±5.03°, 47.03°±9.42°, and 41.30°±9.55° in females, respectively. The same dimensions were -4.25°±8.62°, -0.53°±5.49°, -0.02°±5.57°, 44.90°±8.40°, and 44.82°±9.19° in males, respectively. Post hoc test demonstrated that the SIA and STA values showed significant differences across age groups 1 to 6.
Conclusion: This study provides data that may serve as a reference for distinguishing between normal and pathological anatomy, while also offering essential anatomical and radiological parameters that will enable clinicians particularly radiologists and orthopedic surgeons to assess, reconstruct and design this anatomical structure.
Anahtar Kelimeler
Shoulder joint glenoid version scapulothoracic angle scapular inclination
Kaynakça
- McCausland C, Sawyer E, Eovaldi BJ, Varacallo M. Anatomy, shoulder and upper limb, shoulder muscles. In: StatPearls, Treasure Island (FL), StatPearls Publishing. 2023.
- Aliaj K, Lawrence RL, Bo Foreman K, Chalmers PN, Henninger HB. Kinematic coupling of the glenohumeral and scapulothoracic joints generates humeral axial rotation. J Biomech. 2022;136:111059.
- Fulin P, Kysilko M, Pokorny D, Padr R, Kasprikova N, Landor I et al. Study of the variability of scapular inclination and the glenoid version - considerations for preoperative planning: clinical-radiological study. BMC Musculoskelet Disord. 2017;18:16.
- Ingelaere B, De Boey S, Cappaert R, Van Tongel A, De Wilde L. Three-dimensional glenohumeral relationship in cuff tear arthropathy and its correlation with the type of cuff tear. JSES Int. 2023;8:1182-8.
- Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res. 1993;291:20-8.
- Lugo R, Kung P, Ma CB. Shoulder biomechanics. Eur J Radiol. 2008;68:16-8.
- Parsons IM, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002;20:439-46.
- Gumina S, Villani C, Carbone S, Venditto T, Candela V. Glenoid version: the role of genetic and environmental factors on its variability. An MRI study on asymptomatic elderly twins. Shoulder Elbow. 2022;14:55-9.
- Robertson DD, Sharma GB, McMahon PJ, Karas SG. Glenoid version assessment when the ct field of view does not permit the friedman method: the robertson method. Orthop J Sports Med. 2022;10:23259671221083589.
- Koç MR, Korucu İH, Yucens M, Yörükoğlu AÇ, Sallı A, Yalçın Ş et al. Do the changes of scapulothoracic angle affect winged scapula development and functional scores during clavicle fracture treatment? Acta Ortop Bras. 2022;30:e247742.
- Itoi E, Motzkin NE, Morrey BF, An KN. Scapular inclination and inferior stability of the shoulder. J Shoulder Elbow Surg. 1992;1:131-9.
- Bodanki C, Yadoji HK, Maryada VR, Annapareddy Venkata GR. Three dimensional anthropometric analysis of glenoid anatomy in normal Indian population. Indian J Orthop. 2021;55:861-8.
- Tétreault P, Krueger A, Zurakowski D, Gerber C. Glenoid version and rotator cuff tears. J Orthop Res. 2004;22:202-7.
- Tokgoz N, Kanatli U, Voyvoda NK, Gultekin S, Bolukbasi S, Tali ET. The relationship of glenoid and humeral version with supraspinatus tendon tears. Skeletal Radiol. 2007;36:509-14.
- Aygün Ü, Çalik Y, Işik C, Şahin H, Şahin R, Aygün DÖ. The importance of glenoid version in patients with anterior dislocation of the shoulder. J Shoulder Elbow Surg. 2016;25:1930-6.
- Kikuchi K, Itoi E, Yamamoto N, Seki N, Abe H, Minagawa H et al. Scapular inclination and glenohumeral joint stability: a cadaveric study. J Orthop Sci. 2008;13:72-7.
- De Wilde L, Defoort S, Verstraeten TR, Speeckaert W, Debeer P. A 3D-CT scan study of the humeral and glenoid planes in 150 normal shoulders. Surg Radiol Anat. 2012;34:743-50.
- Lewis GS, Bryce CD, Davison AC, Hollenbeak CS, Piazza SJ, Armstrong AD. Location of the optimized centerline of the glenoid vault: a comparison of two operative techniques with use of three-dimensional computer modeling. J Bone Joint Surg Am. 2010;92:1188–94.
- Pearl ML. Proximal humeral anatomy in shoulder arthroplasty: implications for prosthetic design and surgical technique. J Shoulder Elbow Surg. 2005;14:99–104.
- Bullock GS, Strahm J, Hulburt TC, Beck EC, Waterman BR, Nicholson KF. Relationship between clinical scapular assessment and scapula resting position, shoulder strength, and baseball pitching kinematics and kinetics. Orthop J Sports Med. 2021;9:2325967121991146.
- Oenning S, de Castillo C, Jacob E, Riegel A, Michel PA, Wermers J et al. The clinical impact of glenoid concavity and version on anterior shoulder stability. JSES Int. 2024;9:62-9.
- Piponov HI, Savin D, Shah N, Esposito D, Schwartz B, Moretti V et al. Glenoid version and size: does gender, ethnicity, or body size play a role?. Int Orthop. 2016;40:2347-53.
- Bouchaib J, Clavert P, Kempf JF, Kahn JL. Morphological analysis of the glenoid version in the axial plane according to age. Surg Radiol Anat. 2014;36:579-85.
- Sonve AS, Joshi AR, Rai PR, Achhapalia Y. Determining the normal glenoid version in the Indian population. Indian J Radiol Imaging. 2024;34:435-40.
- Mizuno N, Nonaka S, Ozaki R, Yoshida M, Yoneda M, Walch G. Three-dimensional assessment of the normal Japanese glenoid and comparison with the normal French glenoid. Orthop Traumatol Surg Res. 2017;103:1271-75.
- Matsumura N, Ogawa K, Kobayashi S, Oki S, Watanabe A, Ikegami H Ee al. Morphologic features of humeral head and glenoid version in the normal glenohumeral joint. J Shoulder Elbow Surg. 2014;23:1724-30.
- Sarı A, Dinçel YM, Günaydın B, Çetin MÜ, Özçaglayan Ö, Bilsel K. Assessment of the glenoid morphology based on demographic data in the Turkish population. Biomed Res Int. 2020;2020:5736136.
- Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am. 1992;74:1032-37.
- Tackett JJ, Ablove RH. Magnetic resonance imaging study of glenohumeral relationships between genders. J Shoulder Elbow Surg. 2011;20:1335-39
Sağlıklı yetişkin bireylerde skapular eğimin, glenoid versiyonun ve torakoskapular açının radyolojik ve anatomik değerlendirmesi
Öz
Amaç: Bu çalışmanın amacı, sağlıklı bir popülasyonda doğal glenoid versiyonunun, skapulotorasik açının ve skapular inklinasyon açısının normal referans değerlerini belirleyerek, bu parametrelerin yaş ve cinsiyete göre değişiklik gösterip göstermediğini belirlemektir.
Gereç ve Yöntem: Bu çalışma, yaşları 21-75 arasında değişen 120 sağlıklı yetişkin (58 kadın; 62 erkek) üzerinde Bilgisayarlı Tomografi (BT) kullanılarak gerçekleştirildi. Veriler sağlıklı yetişkin kadın ve erkekler olmak üzere iki gruba ve ayrıca yaşa göre altı gruba ayrıldı. Beş parametre değerlendirildi. Glenoid versiyonu orta versiyon (GVM), alt versiyon (GVB) ve üst versiyon (GVA) olmak üzere üç seviyede ölçüldü.
Bulgular: Kadınların ve erkeklerin yaş ortalamaları sırasıyla 51,54±20,16 yıl ve 49,60±18,82 yıldır. VA, VM, VB, SIA ve STA kadınlarda sırasıyla 5,53°±8,01°, -0,02°±5,08°, 1,37°±5,03°, 47,03°±9,42° ve 41,30°±9,55° olarak bulunmuştur. Aynı parametreler erkeklerde sırasıyla -4,25°±8,62°, -0,53°±5,49°, -0,02°±5,57°, 44,90°±8,40° ve 44,82°±9,19° idi. Ayrıca Post Hoc testine göre, SIA ve STA parametreleri grup 1 ile 6 arasında anlamlı bir fark gösterdi.
Sonuç: Bu çalışma, normal anatomi ile patolojik anatomiyi ayırt edebilmek açısından referans oluşturabilecek veriler sağlarken; özellikle radyologlar ve ortopedik cerrahlar başta olmak üzere klinisyenlerin bu anatomik yapıyı değerlendirmelerine, yeniden yapılandırmalarına ve yeniden tasarlamalarına olanak sağlayacak temel anatomik ve radyolojik veriler sunmaktadır.
Anahtar Kelimeler
Omuz eklemi glenoid versiyon skapulathorasik açı skapular inklinasyon
Kaynakça
- McCausland C, Sawyer E, Eovaldi BJ, Varacallo M. Anatomy, shoulder and upper limb, shoulder muscles. In: StatPearls, Treasure Island (FL), StatPearls Publishing. 2023.
- Aliaj K, Lawrence RL, Bo Foreman K, Chalmers PN, Henninger HB. Kinematic coupling of the glenohumeral and scapulothoracic joints generates humeral axial rotation. J Biomech. 2022;136:111059.
- Fulin P, Kysilko M, Pokorny D, Padr R, Kasprikova N, Landor I et al. Study of the variability of scapular inclination and the glenoid version - considerations for preoperative planning: clinical-radiological study. BMC Musculoskelet Disord. 2017;18:16.
- Ingelaere B, De Boey S, Cappaert R, Van Tongel A, De Wilde L. Three-dimensional glenohumeral relationship in cuff tear arthropathy and its correlation with the type of cuff tear. JSES Int. 2023;8:1182-8.
- Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res. 1993;291:20-8.
- Lugo R, Kung P, Ma CB. Shoulder biomechanics. Eur J Radiol. 2008;68:16-8.
- Parsons IM, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002;20:439-46.
- Gumina S, Villani C, Carbone S, Venditto T, Candela V. Glenoid version: the role of genetic and environmental factors on its variability. An MRI study on asymptomatic elderly twins. Shoulder Elbow. 2022;14:55-9.
- Robertson DD, Sharma GB, McMahon PJ, Karas SG. Glenoid version assessment when the ct field of view does not permit the friedman method: the robertson method. Orthop J Sports Med. 2022;10:23259671221083589.
- Koç MR, Korucu İH, Yucens M, Yörükoğlu AÇ, Sallı A, Yalçın Ş et al. Do the changes of scapulothoracic angle affect winged scapula development and functional scores during clavicle fracture treatment? Acta Ortop Bras. 2022;30:e247742.
- Itoi E, Motzkin NE, Morrey BF, An KN. Scapular inclination and inferior stability of the shoulder. J Shoulder Elbow Surg. 1992;1:131-9.
- Bodanki C, Yadoji HK, Maryada VR, Annapareddy Venkata GR. Three dimensional anthropometric analysis of glenoid anatomy in normal Indian population. Indian J Orthop. 2021;55:861-8.
- Tétreault P, Krueger A, Zurakowski D, Gerber C. Glenoid version and rotator cuff tears. J Orthop Res. 2004;22:202-7.
- Tokgoz N, Kanatli U, Voyvoda NK, Gultekin S, Bolukbasi S, Tali ET. The relationship of glenoid and humeral version with supraspinatus tendon tears. Skeletal Radiol. 2007;36:509-14.
- Aygün Ü, Çalik Y, Işik C, Şahin H, Şahin R, Aygün DÖ. The importance of glenoid version in patients with anterior dislocation of the shoulder. J Shoulder Elbow Surg. 2016;25:1930-6.
- Kikuchi K, Itoi E, Yamamoto N, Seki N, Abe H, Minagawa H et al. Scapular inclination and glenohumeral joint stability: a cadaveric study. J Orthop Sci. 2008;13:72-7.
- De Wilde L, Defoort S, Verstraeten TR, Speeckaert W, Debeer P. A 3D-CT scan study of the humeral and glenoid planes in 150 normal shoulders. Surg Radiol Anat. 2012;34:743-50.
- Lewis GS, Bryce CD, Davison AC, Hollenbeak CS, Piazza SJ, Armstrong AD. Location of the optimized centerline of the glenoid vault: a comparison of two operative techniques with use of three-dimensional computer modeling. J Bone Joint Surg Am. 2010;92:1188–94.
- Pearl ML. Proximal humeral anatomy in shoulder arthroplasty: implications for prosthetic design and surgical technique. J Shoulder Elbow Surg. 2005;14:99–104.
- Bullock GS, Strahm J, Hulburt TC, Beck EC, Waterman BR, Nicholson KF. Relationship between clinical scapular assessment and scapula resting position, shoulder strength, and baseball pitching kinematics and kinetics. Orthop J Sports Med. 2021;9:2325967121991146.
- Oenning S, de Castillo C, Jacob E, Riegel A, Michel PA, Wermers J et al. The clinical impact of glenoid concavity and version on anterior shoulder stability. JSES Int. 2024;9:62-9.
- Piponov HI, Savin D, Shah N, Esposito D, Schwartz B, Moretti V et al. Glenoid version and size: does gender, ethnicity, or body size play a role?. Int Orthop. 2016;40:2347-53.
- Bouchaib J, Clavert P, Kempf JF, Kahn JL. Morphological analysis of the glenoid version in the axial plane according to age. Surg Radiol Anat. 2014;36:579-85.
- Sonve AS, Joshi AR, Rai PR, Achhapalia Y. Determining the normal glenoid version in the Indian population. Indian J Radiol Imaging. 2024;34:435-40.
- Mizuno N, Nonaka S, Ozaki R, Yoshida M, Yoneda M, Walch G. Three-dimensional assessment of the normal Japanese glenoid and comparison with the normal French glenoid. Orthop Traumatol Surg Res. 2017;103:1271-75.
- Matsumura N, Ogawa K, Kobayashi S, Oki S, Watanabe A, Ikegami H Ee al. Morphologic features of humeral head and glenoid version in the normal glenohumeral joint. J Shoulder Elbow Surg. 2014;23:1724-30.
- Sarı A, Dinçel YM, Günaydın B, Çetin MÜ, Özçaglayan Ö, Bilsel K. Assessment of the glenoid morphology based on demographic data in the Turkish population. Biomed Res Int. 2020;2020:5736136.
- Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am. 1992;74:1032-37.
- Tackett JJ, Ablove RH. Magnetic resonance imaging study of glenohumeral relationships between genders. J Shoulder Elbow Surg. 2011;20:1335-39
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Ortopedi |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 18 Şubat 2025 |
| Kabul Tarihi | 23 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 50 Sayı: 2 |
