The Ellipse modification of the Friedman method for measuring glenoid version

Bone Joint J. 2020 Feb;102-B(2):232-238. doi: 10.1302/0301-620X.102B2.BJJ-2019-0726.R1.

Abstract

Aims: Accurate measurement of the glenoid version is important in performing total shoulder arthroplasty (TSA). Our aim was to evaluate the Ellipse method, which involves formally defining the vertical mid-point of the glenoid prior to measuring the glenoid version and comparing it with the 'classic' Friedman method.

Methods: This was a retrospective study which evaluated 100 CT scans for patients who underwent a primary TSA. The glenoid version was measured using the Friedman and Ellipse methods by two senior observers. Statistical analyses were performed using the paired t-test for significance and the Bland-Altman plot for agreement.

Results: The mean glenoid version was -3.11° (-23.8° to 17.9°) using the Friedman method and -1.95° (-29.8° to 24.6°) using the Ellipse method (p = 0.002). In 16 patients the difference between methods was greater than 5°, which we considered to be clinically significant. There was poor agreement between methods with relatively large 95% limits of agreement. There was excellent inter-rater agreement between the observers for the Ellipse method and similarly, the intrarater agreement was excellent with a repeatability coefficient of 0.94.

Conclusion: We recommend the use of the Ellipse modification to define the mid glenoid point prior to measuring the glenoid version in patients undergoing TSA. Cite this article: Bone Joint J 2020;102-B(2):232-238.

Keywords: Ellipse; Friedman; Glenoid; Method; Shoulder Arthroplasty; Version.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Weights and Measures
  • Bone Malalignment / diagnostic imaging*
  • Coracoid Process / diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scapula / diagnostic imaging*
  • Tomography, X-Ray Computed
  • Young Adult