A computed tomography analysis of three-dimensional glenoid orientation modified by glenoid torsion

BACKGROUND: The longitudinal axis of the glenoid is not always parallel to the scapular body, and glenoid torsion could affect the values of glenoid orientation. The purpose of this study was to evaluate 3-dimensional glenoid version and inclination modified by glenoid torsion and to clarify the differences between the values of conventional and of modified glenoid orientations. METHODS: Computed tomography scans of 30 shoulders without shoulder pathology, 30 shoulders with primary osteoarthritis, and 30 shoulders with a massive rotator cuff tear or cuff tear arthropathy were retrospectively evaluated. After determining the glenoid axis and the scapular planes and calculating conventional glenoid version and inclination, modified glenoid version and inclination, and glenoid torsion, the values of conventional glenoid orientation and those of modified glenoid orientation were compared statistically. RESULTS: All shoulders showed anterior torsion of the glenoid with an average of 16° ± 5°. The values of modified glenoid retroversion were significantly smaller than those of conventional glenoid retroversion in all groups (P < .033), and the values of the modified glenoid inferior inclination were significantly larger than those of conventional glenoid inferior inclination in all groups (P < .001). CONCLUSIONS: The present study showed that the glenoid twists with respect to the scapular body and that modification by glenoid torsion could affect the values of glenoid orientation. These results indicated that glenoid orientation with respect to the glenoid longitudinal axis will help surgeons determine proper placement of the glenoid component during shoulder arthroplasty.