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The pillars of the scapula

Anne Karelse, LORE KEGELS and Lieven De Wilde UGent (2007) CLINICAL ANATOMY. 20(4). p.392-399
abstract
Total shoulder replacement has been shown to provide predictable pain relief and functional improvement in patients with glenohumeral arthritis. Loosening of the glenoid component remains the most frequent indication for revision surgery at long-term follow-up. The component most widely used is an all-polyethylene keeled or pegged design cemented to the glenoid cavity of the scapula. The glenoid is small and its cup-shaped morphology allows only a restricted site for limited fixation devices. This is particularly so in revision surgery where there are often large bony defects of the glenoid. In an anatomical study, we investigated the scapula in order to identify substantial bony pillars for better component fixation. Forty cadaveric shoulders (mean age 86, range 67-101) were dissected, the glenoids were denuded from cartilage, and the subchondral and cancellous bone was removed. Two bony pillars approaching the glenoid were consistently identified in all scapulae investigated. These pillars were outlined by three cortices and orientated to the circle formed by the rim of the inferior quadrants of the glenoid. One pillar is directed inferiorly near the margo lateralis and the other pillar is directed superiorly into the spine of the scapula. We defined these pillars in length and direction, and three-dimensionally located them in relation to the joint surface. This study demonstrated two bony pillars as important anatomical landmarks in the scapula. They were constant in presence, surgically accessible, and have not been described before. These results can be used as a guideline in the development of prosthetic designs to improve the fixation of glenoid components.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
GLENOID COMPONENTS, scapula, TOTAL SHOULDER ARTHROPLASTY, glenoid, prosthesis, anatomy, GLENOHUMERAL OSTEOARTHRITIS, COMPUTED-TOMOGRAPHY, REPLACEMENT, BONE, HEMIARTHROPLASTY, POLYETHYLENE, MULTICENTER, PROSTHESIS
journal title
CLINICAL ANATOMY
Clin. Anat.
volume
20
issue
4
pages
392 - 399
Web of Science type
Article
Web of Science id
000245660100010
JCR category
ANATOMY & MORPHOLOGY
JCR impact factor
0.626 (2007)
JCR rank
15/15 (2007)
JCR quartile
4 (2007)
ISSN
0897-3806
DOI
10.1002/ca.20420
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
391234
handle
http://hdl.handle.net/1854/LU-391234
date created
2008-03-05 11:32:00
date last changed
2016-12-19 15:44:13
@article{391234,
  abstract     = {Total shoulder replacement has been shown to provide predictable pain relief and functional improvement in patients with glenohumeral arthritis. Loosening of the glenoid component remains the most frequent indication for revision surgery at long-term follow-up. The component most widely used is an all-polyethylene keeled or pegged design cemented to the glenoid cavity of the scapula. The glenoid is small and its cup-shaped morphology allows only a restricted site for limited fixation devices. This is particularly so in revision surgery where there are often large bony defects of the glenoid. In an anatomical study, we investigated the scapula in order to identify substantial bony pillars for better component fixation. Forty cadaveric shoulders (mean age 86, range 67-101) were dissected, the glenoids were denuded from cartilage, and the subchondral and cancellous bone was removed. Two bony pillars approaching the glenoid were consistently identified in all scapulae investigated. These pillars were outlined by three cortices and orientated to the circle formed by the rim of the inferior quadrants of the glenoid. One pillar is directed inferiorly near the margo lateralis and the other pillar is directed superiorly into the spine of the scapula. We defined these pillars in length and direction, and three-dimensionally located them in relation to the joint surface. This study demonstrated two bony pillars as important anatomical landmarks in the scapula. They were constant in presence, surgically accessible, and have not been described before. These results can be used as a guideline in the development of prosthetic designs to improve the fixation of glenoid components.},
  author       = {Karelse, Anne and KEGELS, LORE and De Wilde, Lieven},
  issn         = {0897-3806},
  journal      = {CLINICAL ANATOMY},
  keyword      = {GLENOID COMPONENTS,scapula,TOTAL SHOULDER ARTHROPLASTY,glenoid,prosthesis,anatomy,GLENOHUMERAL OSTEOARTHRITIS,COMPUTED-TOMOGRAPHY,REPLACEMENT,BONE,HEMIARTHROPLASTY,POLYETHYLENE,MULTICENTER,PROSTHESIS},
  language     = {eng},
  number       = {4},
  pages        = {392--399},
  title        = {The pillars of the scapula},
  url          = {http://dx.doi.org/10.1002/ca.20420},
  volume       = {20},
  year         = {2007},
}

Chicago
Karelse, Anne, LORE KEGELS, and Lieven De Wilde. 2007. “The Pillars of the Scapula.” Clinical Anatomy 20 (4): 392–399.
APA
Karelse, A., KEGELS, L., & De Wilde, L. (2007). The pillars of the scapula. CLINICAL ANATOMY, 20(4), 392–399.
Vancouver
1.
Karelse A, KEGELS L, De Wilde L. The pillars of the scapula. CLINICAL ANATOMY. 2007;20(4):392–9.
MLA
Karelse, Anne, LORE KEGELS, and Lieven De Wilde. “The Pillars of the Scapula.” CLINICAL ANATOMY 20.4 (2007): 392–399. Print.