Glenoid version and size: does gender, ethnicity, or body size play a role?

Abstract

Introduction: Variations in glenoid morphology among patients of different gender, body habitus, and ethnicity have been of interest for surgeons. Understanding these anatomical variations is a critical step in restoring normal glenohumeral structure during shoulder reconstruction surgery.

Methods: Retrospective review of 108 patient shoulder CT scans was performed and glenoid version, AP diameter and height were measured. Statistical multiple regression models were used to investigate the ability of gender and ethnicity to predict glenoid AP diameter, height, and version independently of patient weight and height.

Results: The mean glenoid AP diameter was 24.7 ± 3.5, the mean glenoid height was 31.7 ± 3.7, and the mean glenoid version was 0.05 ± 9.05. According to our regression models, males would be expected to exhibit 8.4° more glenoid retroversion than females (p = 0.003) and have 2.9 mm larger glenoid height compared to females (p = 0.002). The predicted male glenoid AP diameter was 3.4 mm higher than that in females (p < 0.001). Hispanics demonstrated 6.4° more glenoid anteversion compared to African-Americans (p = 0.04). Asians exhibited 4.1 mm smaller glenoid AP diameters than African-Americans (p = 0.002). An increase of 25 kg in patient weight resulted in 1 mm increase in AP diameter (p = 0.01).

Conclusions: Gender is the strongest independent predictor of glenoid size and version. Males exhibited a larger size and more retroverted glenoid. Patient height was found to be predictive of glenoid size only in patients of the same gender. Although variations in glenoid size and version are observed among ethnicities, larger sample size ethnic groups will be necessary to explore the precise relations. Surgeons should consider gender and ethnic variations in the pre-operative planning and surgical restoration of the native glenohumeral relationship.

Level of evidence: Anatomic Study.

Keywords: Glenoid AP diameter and height; Glenoid version; Multiple regression model; Patient height and weight; Total shoulder arthroplasty.