Aims The aim of this study was to determine whether there is a correlation between the grade of humeral osteoarthritis (OA) and the severity of glenoid morphology according to Walch. We hypothesized that there would be a correlation. Methods Overal, 143 shoulders in 135 patients (73 females, 62 males) undergoing shoulder arthroplasty surgery for primary glenohumeral OA were included consecutively. Mean age was 69.3 years (47 to 85). Humeral head (HH), osteophyte length (OL), and morphology (transverse decentering of the apex, transverse, or coronal asphericity) on radiographs were correlated to the glenoid morphology according to Walch (A1, A2, B1, B2, B3), glenoid retroversion, and humeral subluxation on CT images. Results Increased humeral OL correlated with a higher grade of glenoid morphology (A1-A2-B1-B2-B3) according to Walch (r = 0.672; p < 0.0001). It also correlated with glenoid retroversion (r = 0.707; p < 0.0001), and posterior humeral subluxation (r = 0.452; p < 0.0001). A higher humeral OL (odds ratio (OR) 1.17; 95% confidence interval (CI) 1.03 to 1.32; p = 0.013), posterior humeral subluxation (OR 1.11; 95% CI 1.01 to 1.22; p = 0.031), and glenoid retroversion (OR 1.48; 95% CI 1.30 to 1.68; p < 0.001) were independent factors for a higher glenoid morphology. More specifically, a humeral OL of >= 13 mm was indicative of eccentric glenoid types B2 and B3 (OR 14.20; 95% CI 5.96 to 33.85). Presence of an aspherical HH in the coronal plane was suggestive of glenoid types B2 and B3 (OR 3.34; 95% CI 1.67 to 6.68). Conclusion The criteria of humeral OL and HH morphology are associated with increasing glenoid retroversion, posterior humeral subluxation, and eccentric glenoid wear. Therefore, humeral radiological parameters might hint at the morphology on the glenoid side.

Background: Concomitant glenohumeral pathologies may be present in patients with acromioclavicular joint (ACJ) dislocations. This study aims to record and compare the prevalence and treatment of CGP in cases with acute and chronic ACJ dislocations. Methods: This retrospective cross-sectional binational, bicentric study included patients that underwent arthroscopically assisted stabilization for acute (group A) and chronic (group C) ACJ dislocations. Intraoperatively, CGPs and eventual treatments (debridement and reconstructive measures) were recorded. Results: The study included 540 patients (87% men; mean age 39.4 years), with 410 (75.9%) patients in group A and 130 (24.1%) in group C. Patients in group C were older (p < 0.001). The CGP prevalence was 30.7%, without a difference between groups A and C (p = 0.19). Supraspinatus tendon (SSP) and labral lesions were most common. Within group C, CGPs were more prevalent in surgery-naïve patients (p = 0.002). Among 49 patients with previous surgical treatment, CGPs tended to be more common in patients with prior open surgery than arthroscopically assisted surgery (p = 0.392). Increased CGP prevalence was associated with higher age (r = 0.97; p = 0.004) (up to 63% in the oldest age group, but also 17% for youngest age group) and higher in cases with Rockwood type-IIIB injuries compared to type-V injuries (p = 0.028), but type-IIIB injuries included more group C cases (p < 0.001). The most frequently found CGPs were treated by debridement rather than reconstructive interventions (SSP and labrum: p < 0.001, respectively). Conclusions: This study shows that one in three patients with ACJ instabilities has a CGP, especially elderly patients. Most of the CGPs were treated by debridement rather than constructive interventions.

Acromioclavicular joint (ACJ) dislocations have been linked to altered scapulothoracic orientation and scapula dyskinesis, but research on three-dimensional (3D) changes in scapulothoracic orientation after such injury in vivo has not been described before. The aim of our pilot study was to analyze scapulothoracic orientation changes in patients with ACJ dislocations using three-dimensional computed tomographic (CT) image reconstruction. Patients with ACJ dislocations who underwent CT imaging were included retrospectively and consecutively. Minors and cases with spine, neurologic or systemic diseases, and shoulder girdle fractures were excluded. Each CT was performed in supine position with elbows rested on the scanning table and had to depict the complete shoulder girdle. After 3D image reconstruction, tilt, upward rotation, internal rotation, translation, and protraction of the scapula were measured based on three osseous landmarks: the glenoid (the deepest point of its concavity), the medial root of the scapular spine, and the inferior scapular angle. The healthy contralateral side was used as a paired control. ACJ dislocations were graded according to Rockwood (RW) on strict frontal CT image reconstruction, including the contralateral shoulder, where measurements were also performed to enable comparison. Cases were labeled as acute or chronic with a 3-week injury-to-diagnosis interval cut-off. The mean age of the 14 patients (11 males and 3 females) was 38.6 ± 15.6 years (range, 18-71). Ten cases were defined as acute (RW types II: 1; III: 3; V: 6) and four as chronic (II: 1; III: 2; V: 1). On the injured side, the scapula showed more internal rotation (46.2° ± 5.3° vs. 42.1° ± 4.4°; P = .003), more scapular tilt (20.2° ± 4.6° vs. 17.9° ± 3.5°; P = .022), and less upward rotation (10.1° ± 3.6° vs. 12.0° ± 4.8°; P = .043). No difference between sides was found for scapular translation (P = .342) and scapular protraction (P = .385). There was a trend toward more internal rotation for RW type V injuries (P = .097). In this first 3D in vivo study, patients with ACJ dislocations displayed changes in scapulothoracic orientation in all planes. The scapula of the injured side was more internally rotated, forwardly tilted, and less upwardly rotated than on the healthy contralateral side.

Purpose: To evaluate joint reduction (loss of reduction [LOR]; dynamic posterior translation [DPT]) and clavicular tunnel widening (cTW) in patients treated with arthroscopically‐assisted acromioclavicular joint (ACJ) stabilization after previously failed nonoperative versus surgical treatment.Methods: Patients undergoing arthroscopically‐assisted ACJ stabilization (bidirectional tendon allograft with a low‐profile TightRope) after previously failed nonoperative versus surgical treatment were included retrospectively. Bilateral anteroposterior stress views served for evaluating LOR (side‐comparative coracoclavicular distance [CCD]) and cTW at a 6‐weeks‐ and 6‐months‐follow‐up (FU) and for evaluating the filling ratio (FR, vertical device insertion depth relative to clavicle height) at the 6‐weeks‐FU. Postoperative DPT was assessed on Alexander's views.Results: Twenty‐seven patients (20 male, mean age 46.1 ± 14.8 years) were included (prior treatment: nonoperative: n = 15; surgical: n = 12). There were no differences in LOR, DPT or cTW between groups postoperatively. Initial CCD‐symmetry at the 6‐weeks‐FU (CCD: −0.1 mm [95% confidence interval, CI, −2 to 1.4 mm]) was followed by LOR at the 6‐months‐FU (CCD: −3.5 mm [95% CI, −5.2 to −1.9 mm]; p < 0.001). cTW increased towards the inferior cortex, compared to the superior cortex and the intermediate level (p < 0.001, respectively). cTW at the inferior cortex was associated with more LOR (r = −0.449; p = 0.024) and DPT (r = 0.421; p = 0.036), dependent on a smaller FR (r = −0.430; p = 0.032).Conclusion: Patients undergoing arthroscopically‐assisted ACJ stabilization for chronic bidirectional ACJ instabilities showed comparable radiologic results after previous nonoperative versus surgical treatment. cTW increased towards the inferior cortex and was associated with recurrent vertical and horizontal instability, related to a smaller FR. More research into reduced cTW, for example, by a more filling device, should be performed.Level of Evidence: Level III, retrospective comparative study.