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Review
. 2019 Jul 9:3:2471549219861811.
doi: 10.1177/2471549219861811. eCollection 2019.

Imaging of the B2 Glenoid: An Assessment of Glenoid Wear

Jared M Mahylis  1 , Vahid Entezari  2 , Bong-Jae Jun  2 , Joseph P Iannotti  2 , Eric T Ricchetti  2
Affiliations
Review

Imaging of the B2 Glenoid: An Assessment of Glenoid Wear

Jared M Mahylis et al. J Shoulder Elb Arthroplast. .

Abstract

Background: Glenohumeral osteoarthritis (OA) carries a spectrum of morphology and wear patterns of the glenoid surface exemplified by complex patterns such as glenoid biconcavity and acquired retroversion seen in the B2 glenoid. Multiple imaging methods are available for evaluation of the complex glenoid structure seen in B2 glenoids. The purpose of this article is to review imaging assessment of the type B2 glenoid.

Methods: The current literature on imaging of the B2 glenoid was reviewed to describe the unique anatomy of this OA variant and how to appropriately assess its characteristics.

Results: Plain radiographs, magnetic resonance imaging, and standard 2-dimensional computed tomography (CT) have all shown acceptable assessments of arthritic glenoids but lack the detailed and highly accurate evaluation of bone loss and retroversion seen with 3-dimensional CT.

Conclusion: Accurate preoperative identification of complex B2 pathology on imaging remains essential in planning and achieving precise implant placement at the time of shoulder arthroplasty.

Keywords: B2 glenoid; biconcave glenoid; glenohumeral arthritis.

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Conflict of interest statement

The author(s) declare the following potential conflicts of interest with respect to the research, authorship, and/or publication of the article: Royalties—Arthrex, DePuy-Synthes, Wright-Tornier, DJO; Consultant—DJO; Paid speaker/presenter—DJO; Financial/Material Support—JBJS, Wolters Kluwer Health—Lippincott Williams & Wilkins; Stock or stock options—Custom Orthopaedic Solutions; Board/Committee Member—AAOS, ABOS, ASES.

Figures

Figure 1.
Figure 1.
Walch classification of glenoid morphology in primary glenohumeral arthritis (reprinted with permission from Elsevier from Walch et al.).
Figure 2.
Figure 2.
3D CT of 59-year-old man with B2 glenoid. A, Type B2 glenoid demonstrating pathologic retroversion due to bone loss. Bone measurements: version = −15.9°, inclination = 7.1°. B, Vault model placed in same patient representing premorbid glenoid measurements: version = −9°, inclination = 7°. C, 3D reconstruction showing biconcavity. D, 3D reconstruction showing increased retroversion of glenoid plane (green) relative to scapular plane (blue).
Figure 3.
Figure 3.
Modified Walch classification. Note that a line drawn from the anterior to posterior native glenoid rim transects the humeral head in A2 glenoid but not in the A1 glenoid (reprinted with permission from Elsevier from Bercik et al.).
Figure 4.
Figure 4.
CT scan examples of 4 B3 glenoids and classification according to original Walch classification. Note that the B3 glenoid has both central and asymmetric posterior bone loss, increased medialization, and little to no paleoglenoid unlike the B2 (reprinted with permission from Lippincott Williams & Wilkins from Iannotti et al.).
Figure 5.
Figure 5.
CT scan examples of 4 C2 glenoids and classification according to original Walch classification. In similarity to the B2 glenoid, the C2 glenoid has a biconcave surface with associated posterior humeral head subluxation; however, pathologic glenoid retroversion and the premorbid glenoid version are both greater in the C2 glenoid (reprinted with permission from Lippincott Williams & Wilkins from Iannotti et al.).
Figure 6.
Figure 6.
The orientation of the greatest erosion in B glenoid (reprinted with permission from Elsevier from Beuckelaers et al.).
See this image and copyright information in PMC

References

    1. Kerr R, Resnick D, Pineda C, Haghighi P. Osteoarthritis of the glenohumeral joint: a radiologic-pathologic study. Am J Roentgenol. 1985; 144(5):967–972. - PubMed
    1. Petersson CJ. Degeneration of the glenohumeral joint. An anatomical study. Acta Orthop Scand. 1983; 54(2):277–283. - PubMed
    1. Gartsman GM, Brinker MR, Khan M, Karahan M. Self-assessment of general health status in patients with five common shoulder conditions. J Shoulder Elbow Surg. 1998; 7(3):228–237. - PubMed
    1. Lo IKY, Litchfield RB, Griffin S, Faber K, Patterson SD, Kirkley A. Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis: a prospective, randomized trial. J Bone Joint Surg Am. 2005; 87(10):2178–2185. - PubMed
    1. Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty. 1999; 14:756–760. - PubMed

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