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The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study

Background: Cuff tear arthropathy (CTA) is characterized by superior migration of the humeral head with superior erosion of the glenoid. Rarely, humeral head migration can be anteroinferior with associated anterior erosion of the glenoid, a pattern described by Favard as the type E4 glenoid. The pur...

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Autores principales: Walch, Gilles, Collotte, Philippe, Raiss, Patric, Athwal, George S., Gauci, Marc Olivier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699291/
https://www.ncbi.nlm.nih.gov/pubmed/33218196
http://dx.doi.org/10.3390/jcm9113704
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author Walch, Gilles
Collotte, Philippe
Raiss, Patric
Athwal, George S.
Gauci, Marc Olivier
author_facet Walch, Gilles
Collotte, Philippe
Raiss, Patric
Athwal, George S.
Gauci, Marc Olivier
author_sort Walch, Gilles
collection PubMed
description Background: Cuff tear arthropathy (CTA) is characterized by superior migration of the humeral head with superior erosion of the glenoid. Rarely, humeral head migration can be anteroinferior with associated anterior erosion of the glenoid, a pattern described by Favard as the type E4 glenoid. The purpose of this retrospective imaging study was to analyze the 2D and 3D characteristics of the E4 glenoid. Methods: A shoulder arthroplasty database of 258 cuff tear arthropathies was examined to identify patients with an E4 type deformity. This resulted in a study cohort of 15 females and 2 males with an average age of 75 years. All patients had radiographs and CT scans available for analysis. CT-scan DICOM (Digital Imaging and Communications in Medicine) data were uploaded to a validated three-dimensional (3D) imaging software. Muscle fatty infiltration, glenoid measurements (anteversion, inclination), and humeral head subluxation according to the scapular plane were determined. Results: The mean anteversion and inclination of the E4 cohort were 32° ± 14° and −5° ± 2, respectively. The mean anterior subluxation was 19% ± 16%. All cases had severe grade 3 or 4 fatty infiltration of the infraspinatus, whereas only 65% had grade 3 or 4 subscapularis fatty infiltration. A significant correlation existed between glenoid anteversion and humeral head subluxation (p < 0.001), but no correlation was found with muscle fatty infiltration. The CT analysis demonstrated an acquired erosive biconcave morphology in 11 patients (65%) and monoconcavity in 6 patients (35%). Conclusion: The E4 type glenoid deformity in cuff tear arthropathy is characterized by an anterior erosion and anteversion associated with anterior subluxation of the humeral head.
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spelling pubmed-76992912020-11-29 The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study Walch, Gilles Collotte, Philippe Raiss, Patric Athwal, George S. Gauci, Marc Olivier J Clin Med Article Background: Cuff tear arthropathy (CTA) is characterized by superior migration of the humeral head with superior erosion of the glenoid. Rarely, humeral head migration can be anteroinferior with associated anterior erosion of the glenoid, a pattern described by Favard as the type E4 glenoid. The purpose of this retrospective imaging study was to analyze the 2D and 3D characteristics of the E4 glenoid. Methods: A shoulder arthroplasty database of 258 cuff tear arthropathies was examined to identify patients with an E4 type deformity. This resulted in a study cohort of 15 females and 2 males with an average age of 75 years. All patients had radiographs and CT scans available for analysis. CT-scan DICOM (Digital Imaging and Communications in Medicine) data were uploaded to a validated three-dimensional (3D) imaging software. Muscle fatty infiltration, glenoid measurements (anteversion, inclination), and humeral head subluxation according to the scapular plane were determined. Results: The mean anteversion and inclination of the E4 cohort were 32° ± 14° and −5° ± 2, respectively. The mean anterior subluxation was 19% ± 16%. All cases had severe grade 3 or 4 fatty infiltration of the infraspinatus, whereas only 65% had grade 3 or 4 subscapularis fatty infiltration. A significant correlation existed between glenoid anteversion and humeral head subluxation (p < 0.001), but no correlation was found with muscle fatty infiltration. The CT analysis demonstrated an acquired erosive biconcave morphology in 11 patients (65%) and monoconcavity in 6 patients (35%). Conclusion: The E4 type glenoid deformity in cuff tear arthropathy is characterized by an anterior erosion and anteversion associated with anterior subluxation of the humeral head. MDPI 2020-11-18 /pmc/articles/PMC7699291/ /pubmed/33218196 http://dx.doi.org/10.3390/jcm9113704 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Walch, Gilles
Collotte, Philippe
Raiss, Patric
Athwal, George S.
Gauci, Marc Olivier
The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study
title The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study
title_full The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study
title_fullStr The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study
title_full_unstemmed The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study
title_short The Characteristics of the Favard E4 Glenoid Morphology in Cuff Tear Arthropathy: A CT Study
title_sort characteristics of the favard e4 glenoid morphology in cuff tear arthropathy: a ct study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699291/
https://www.ncbi.nlm.nih.gov/pubmed/33218196
http://dx.doi.org/10.3390/jcm9113704
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