Clinical and Radiological Examination of the Shoulder Joint by Helen Razmjou & Monique Christakis

Author:Helen Razmjou & Monique Christakis
Language: eng
Format: epub
ISBN: 9783031104701
Publisher: Springer International Publishing

© The Author(s), under exclusive license to Springer Nature Switzerland AG 2022

H. Razmjou, M. ChristakisClinical and Radiological Examination of the Shoulder Jointhttps://doi.org/10.1007/978-3-031-10470-1_7

7. Arthritis of the Glenohumeral Joint

Helen Razmjou1, 2

(1)Sunnybrook Health Sciences Centre, Toronto, ON, Canada

(2)Department of Physical Therapy, University of Toronto, Toronto, ON, Canada

Helen Razmjou

Email: [email protected]

Keywords

Primary osteoarthritisSecondary arthritisAnatomical total shoulder arthroplasty

There are two major types of arthritis of the glenohumeral joint. The primary osteoarthritis refers to degeneration of the glenohumeral joint without any identifiable causes, such as systemic diseases or traumatic injuries (idiopathic etiology).

One important radiological feature of primary glenohumeral osteoarthritis is the posterior bone erosion of the glenoid. This very unique pathology is known to be related to increased glenoid retroversion which appears to be affected by independent and complex genetic and biomechanical factors [1]. This may explain why some people are more prone to primary osteoarthritis of the glenohumeral joint. The glenoid version is defined as an angle between the glenoid face and the scapular body. A normal glenoid version is estimated as a mean of 2 ± 5 degrees of glenoid anteversion. This version is significantly different in an arthritic joint, with the glenoid face being tilted backward at about11 ± 8 degrees of retroversion [2]. Association between posterior glenoid wear and posterior humeral head subluxation has been a subject of discussions for a few decades. In 1990, Neer felt that glenoid erosion preceded subluxation, and Walch et al. were able to show that subluxation (dynamic and statistic) proceeded erosion. Walch et al. were able to exclude all potential causes of the subluxation except one thing, and that was increased retroversion of the glenoid [3].

While over the last 20 years our knowledge of glenohumeral arthritis has improved significantly, the exact contribution of osseous morphology vs. contractile and noncontractile soft tissue balance to the development of posterior glenoid subluxation remains unclear. Although the direction of cause and effect is still not clear, the association between the glenoid inclination, posterior humeral head subluxation, and muscle imbalance in the transverse force couple (infraspinatus and teres minor vs. subscapularis) has been reported in multiple independent studies. Aleem et al. [4] reported that the asymmetric posterior glenoid wear and posterior humeral head subluxation in osteoarthritis were associated with asymmetric atrophy within the rotator cuff transverse plane. Hartwell et al. [5] found that the amount of fatty infiltration in the infraspinatus muscle was strongly correlated with the glenoid version. Similarly, Mitterer et al. suggested that increased glenoid retroversion and chronic muscle volume imbalance could increase posterior force during contraction pushing the humeral head posteriorly and contribute to the permanent posterior displacement of the humeral head [6]. To date, however, the exact causative or associative nature of this relationship is not proven. Further discussion of imaging findings of the arthritic shoulder joint has been provided in Chap. 12.

Secondary glenohumeral arthritis is a term used to reflect all other types of arthritis with known predisposing or risk factors, impacting the normal biomechanics, joint structure integrity, joint blood supply, or nutrition. Trauma (e.g., injury related, chronic

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