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Is the Bare Spot a Consistent Landmark for Shoulder Arthroscopy? A Study of 20 Embalmed Glenoids With 3-Dimensional Computed Tomographic Reconstruction

2006; Elsevier BV; Volume: 22; Issue: 4 Linguagem: Inglês

10.1016/j.arthro.2005.12.006

1526-3231

Franz Kralinger, Felix Aigner, Stefano Longato, Michael Rieger, Markus Wambacher,

Orthopedic Surgery and Rehabilitation

Purpose: Our aim was to test a published methodology for arthroscopically quantifying glenoid bone loss for its dependability in a cadaver-based anatomic study with 3-dimensional (3-D) computed tomographic (CT) reconstructions of 20 embalmed glenoids. Methods: Manual macroscopic measurements were made in a standardized fashion. In addition, we marked the center of the visible bare spot in 20 embalmed glenoids with a titanium pin. The shoulder joints were carefully selected for intact rotator cuff, missing capsule-labral deficiency, and absence of severe cartilage degeneration. 3-D reconstructed CT scans were evaluated for consistency of the bare spot. Results: The mean distance from the bare spot to the anterior margin measured manually was 10.9 mm (CT-based, 13.9 mm), to the posterior margin 13.7 mm (CT-based, 16.4 mm), and to the inferior margin 9.7 mm (CT-based, 15.1 mm). Distances were significantly different. Conclusions: The bare spot did not prove its consistency in 20 carefully selected specimens. Therefore, we conclude that this methodology is not a reliable way to intraoperatively determine bony glenoid deficiency. Clinical Relevance: We recommend preoperative bilateral CT scans for evaluation of bony glenoid deficiency for exact quantification of the bone loss. Purpose: Our aim was to test a published methodology for arthroscopically quantifying glenoid bone loss for its dependability in a cadaver-based anatomic study with 3-dimensional (3-D) computed tomographic (CT) reconstructions of 20 embalmed glenoids. Methods: Manual macroscopic measurements were made in a standardized fashion. In addition, we marked the center of the visible bare spot in 20 embalmed glenoids with a titanium pin. The shoulder joints were carefully selected for intact rotator cuff, missing capsule-labral deficiency, and absence of severe cartilage degeneration. 3-D reconstructed CT scans were evaluated for consistency of the bare spot. Results: The mean distance from the bare spot to the anterior margin measured manually was 10.9 mm (CT-based, 13.9 mm), to the posterior margin 13.7 mm (CT-based, 16.4 mm), and to the inferior margin 9.7 mm (CT-based, 15.1 mm). Distances were significantly different. Conclusions: The bare spot did not prove its consistency in 20 carefully selected specimens. Therefore, we conclude that this methodology is not a reliable way to intraoperatively determine bony glenoid deficiency. Clinical Relevance: We recommend preoperative bilateral CT scans for evaluation of bony glenoid deficiency for exact quantification of the bone loss. The Bare Spot of the GlenoidArthroscopyVol. 23Issue 4PreviewI am writing in regard to the study by Kralinger et al. in the April 2006 issue of Arthroscopy entitled “Is the Bare Spot a Consistent Landmark for Shoulder Arthroscopy? A Study of 20 Embalmed Glenoids With 3-Dimensional Computed Tomographic Reconstruction.”1 This study evaluated 20 embalmed glenoids by means of 3-dimensional computed tomographic reconstructions. The study concluded that the glenoid bare spot is not a consistent anatomic landmark for the midpoint of the inferior glenoid. This conclusion directly contradicts the conclusion of a study previously published by our group. Full-Text PDF