This retrospective cohort used serial CT scans to track how glenoid morphology evolves in primary glenohumeral osteoarthritis. It asks whether the Walch glenoid type predicts pathologic progression and whether bone loss correlates with rotator cuff fatty infiltration.
When you see a Walch B1 glenoid, treat it as an early stage rather than a stable endpoint. This study shows B1 glenoids reliably advance to B2 or B3 with posterior bone loss, while A1 glenoids rarely change. That distinction should shape your counseling and follow-up.
The mechanism the authors support is that posterior humeral head subluxation comes first and drives posterior glenoid erosion. B1 was 29% of this non-surgical cohort but only 1.3% of a prior surgical cohort, consistent with B1 being an earlier point on the same disease trajectory.
Because B glenoids erode at roughly 0.70 mm/year, periodic imaging is reasonable, and faster progressors with symptoms become arthroplasty candidates before severe bone loss complicates glenoid reconstruction. The fatty infiltration differences are real but small and within one Goutallier grade, so do not overweight them clinically.
This retrospective cohort used serial CT scans to track how glenoid morphology evolves in primary glenohumeral osteoarthritis. It asks whether the Walch glenoid type predicts pathologic progression and whether bone loss correlates with rotator cuff fatty infiltration.
When you see a Walch B1 glenoid, treat it as an early stage rather than a stable endpoint. This study shows B1 glenoids reliably advance to B2 or B3 with posterior bone loss, while A1 glenoids rarely change. That distinction should shape your counseling and follow-up.
The mechanism the authors support is that posterior humeral head subluxation comes first and drives posterior glenoid erosion. B1 was 29% of this non-surgical cohort but only 1.3% of a prior surgical cohort, consistent with B1 being an earlier point on the same disease trajectory.
Because B glenoids erode at roughly 0.70 mm/year, periodic imaging is reasonable, and faster progressors with symptoms become arthroplasty candidates before severe bone loss complicates glenoid reconstruction. The fatty infiltration differences are real but small and within one Goutallier grade, so do not overweight them clinically.