Is the Walch B3 glenoid significantly worse than the B2?

Abstract

Background

The Walch B3 glenoid is theorized to be a progression of the B2 biconcave pattern. The present study aimed to compare glenoid indices between B2 and B3 patterns. We hypothesized that the B3 pattern would have significantly worse retroversion, inclination and medialization.

Methods

Computed tomography scans of 50 patients with B2 erosions [mean (SD) age 68 (9) years; 25 male] and 50 patients with B3 erosions [mean (SD) age 72 (8) years; 22 males] were converted into three-dimensional reconstructions. Retroversion, inclination, medialization and humeral head subluxation were compared.

Results

The data demonstrated no statistically significant differences [mean (SD)] between groups when assessing retroversion: B2 = 21 (8)°, B3 = 24 (7)° (p = 0.602); glenoid inclination: B2 = 9 (6)°, B3 = 8 (6)° (p = 0.967); or medialization: B2 = 12 (4) mm, B3 = 14 (4) mm (p = 0.384). In the B2 group, the mean (SD) humeral head subluxation was 80% (10%) according to the scapular plane and 55% (9%) according to the glenoid plane, which was not statistically different from the B3 group with a mean (SD) humeral head subluxation of 81% (7%) according to the scapular plane (p = 0.680) and 54% (7%) according to the glenoid plane (p = 0.292).

Conclusions

These results demonstrated no significant differences between the B2 and B3 erosion patterns, with respect to the glenoid indicies measured. The aetiology of the B3 glenoid cannot be completely explained by progression of wear in a B2 glenoid.

Keywords

glenohumeral osteoarthritis shoulder arthritis total shoulder arthroplasty Walch B2 Walch B3

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