Logli, J Shoulder Elbow Surg 2021 - Natural History of Glenoid Bone Loss in Primary Glenohumeral Osteoarthritis: How Does Bone Loss Progress over a Decade?

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Natural History of Glenoid Bone Loss in Primary Glenohumeral Osteoarthritis: How Does Bone Loss Progress over a Decade?

Logli, Sanchez-Sotelo, et al.·J Shoulder Elbow Surg·2021·16 citations·Retrospective cohort

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Background

Progressive glenoid bone loss and humeral head subluxation occur in primary glenohumeral osteoarthritis (GHOA), but less is known about the rate and pattern by which this occurs. The purpose of this study was to determine how glenohumeral subluxation and glenoid bone loss changed over time in shoulders that underwent arthroplasty and had been evaluated with radiographs at 1 or more time points over the 5-15 years before arthroplasty.

Methods

We retrospectively identified 48 shoulders that had been evaluated with high-quality radiographs both before arthroplasty and at least once 5-15 years earlier.
Axillary radiographs were used to classify glenoid morphology using the modified Walch classification on the oldest, most recent, and all intervening radiographs.
The mean interval time between the oldest and most recent radiographs was 8.9 years (range 5-15 years).

Results

Glenoid morphology on the earliest radiograph was classified as A1 in 22, A2 in 13, B1 in 1, B2 in 9, B3 in 1, and D in 2 shoulders.
Walch A patterns identified on early radiographs most commonly maintained an A pattern over time, but 20% developed eccentric wear with 5 of 35 becoming B type and 2 of 35 becoming a D type before arthroplasty.
All B-type glenoids remained B type.
Classic progression of bone loss along the same concentric or eccentric 'track' occurred 41% of the time.

Conclusions

In primary GHOA, humeral head subluxation and glenoid bone loss do progress over time, but not universally and not always through the same pathway.

Level of evidence: Level IV; Case Series; Prognosis Study. Copyright remains with the authors and publisher.

Natural History of Glenoid Bone Loss in Primary Glenohumeral Osteoarthritis: How Does Bone Loss Progress over a Decade?

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Natural History of Glenoid Bone Loss in Primary Glenohumeral Osteoarthritis: How Does Bone Loss Progress over a Decade?

Logli, Sanchez-Sotelo, et al.·J Shoulder Elbow Surg·2021·16 citations·Retrospective cohort

|

Background

Progressive glenoid bone loss and humeral head subluxation occur in primary glenohumeral osteoarthritis (GHOA), but less is known about the rate and pattern by which this occurs. The purpose of this study was to determine how glenohumeral subluxation and glenoid bone loss changed over time in shoulders that underwent arthroplasty and had been evaluated with radiographs at 1 or more time points over the 5-15 years before arthroplasty.

Methods

We retrospectively identified 48 shoulders that had been evaluated with high-quality radiographs both before arthroplasty and at least once 5-15 years earlier.
Axillary radiographs were used to classify glenoid morphology using the modified Walch classification on the oldest, most recent, and all intervening radiographs.
The mean interval time between the oldest and most recent radiographs was 8.9 years (range 5-15 years).

Results

Glenoid morphology on the earliest radiograph was classified as A1 in 22, A2 in 13, B1 in 1, B2 in 9, B3 in 1, and D in 2 shoulders.
Walch A patterns identified on early radiographs most commonly maintained an A pattern over time, but 20% developed eccentric wear with 5 of 35 becoming B type and 2 of 35 becoming a D type before arthroplasty.
All B-type glenoids remained B type.
Classic progression of bone loss along the same concentric or eccentric 'track' occurred 41% of the time.

Conclusions

In primary GHOA, humeral head subluxation and glenoid bone loss do progress over time, but not universally and not always through the same pathway.

Level of evidence: Level IV; Case Series; Prognosis Study. Copyright remains with the authors and publisher.

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