Several authors have done a great job exposing this phenomenon to us all. retroversion angle, based on the axial rotation of the humeral head in an axial transverse plane, is measured as the angle between the axes of the humeral diaphysis and the humeral neck … The anatomic (primary) shoulder allows the surgeon to replicate a patient’s unique anatomy by independently adjusting parameters in situ. Virtually every throwing athlete that you come across will have excessive external rotation on the dominant side with a decreased internal rotation. the definition of humeral head retroversion, different methods of measurement, ranges of normal values, and accuracy of anatomic landmarks to guide determination of anatomic retroversion. There are limited data to support this suggestion. Results: The mean retroversion of the humeral head at the midpoint between the superior and inferior margins was 18.6°. Analysis of Glenoid Component Shift and Osteolysis Following Anatomic Total Shoulder Arthroplasty. We traobserver variation in the measurements was less than 3 hypothesized: (1) normal values of humeral head retro- for each measurement method. 1989; Hawkins Bell and Jallay 1989; Neer 1990; Neer and Kirby 1982; Pearl and Lippitt 1993; Roper Paterson and Day 1990; Weiss Adams Moore et al. Anatomic Augmented Glenoid Implants for the Management of the B2 Glenoid Lisa GM Friedman, MD, MA1 and Grant E Garrigues, MD1 Abstract The B2 glenoid is defined by Walch et al. Results depend on proper implant selecti… Humeral head replacement was carried out based on two arbitrarily fixed angles: inclination and retroversion (2, 3, 4,23,24). There are several different theories as to how exactly this occurs. 365. the arm brings the subscapularis into the eld and farther from . The angle between the humeral neck and a line perpendicular to the axis of the forearm averaged 41 degrees. C HRISTOFORAKIS , George M. K ONTAKIS , Pavlos G. K ATONIS , Thomas M ARIS , This fixed inclination limits the potential for the surgeon to reproduce the original anatomy. Correct RA influences the position of … The consensus as of late seems that humeral retroversion is more strongly related to adaptive changes in proximal humeral anatomy than to changes in the soft tissues. Results of anatomic noncon - strained prosthesis in primary osteoarthritis with biconcave glenoid. as a glenoid that is biconcave with posterior erosion accompanied by posterior humeral head subluxation. We investigated whether preoperative glenoid retroversion and humeral head subluxation are associated with inferior outcomes after TSA and whether change of retroversion influences outcomes after TSA. With increasing angles of retroversion, the base of the humer-al component forms an ellipse in plain radi- ographs. Humeral Retroversion and Its Relationship to Glenohumeral Rotation in the Shoulder of College Baseball Players. Average glenoid retroversion was 1° ± 3°, ranging from −9° to 13°. the following parameters: humeral neck angle, humeral head retroversion, humeral head medial offset, humeral head pos-terior offset, humeral head diameter, glenoid height, glenoid width, and the glenoid height to width ratio. Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. • Centering of the humeral head • Is this possible with moderate to severe glenoid bone loss (B2 glenoid)? Retrotorsion (i.e. The difference obviously being the throwing arm arc of rotation shifts posteriorly. While glenoid retroversion and posterior humeral head decentering are common preoperative features of severely arthritic glenohumeral joints, the relationship of postoperative glenoid component retroversion to the clinical results of total shoulder arthroplasty (TSA) is unclear. In this example we see that total rotation is virtually equal, which is a good thing. This creates unique challenges for the treating orthopedic surgeon. Chinese and Japanese bony dimensions of the shoulder have been found to be different from that of the Caucasian population. 16, 17 However, using the bicipital groove at the surgical neck as an anatomic landmark may create excessive retroversion of the humeral head. In reproduction of humeral head retroversion during humeral head replacement surgery, the lateral fin of the prosthesis should be placed at this location. head subluxation is the percentage of humeral head posterior to the Friedman line (HI/GI). The consensus as of late seems that humeral retroversion is more strongly related to adaptive changes in proximal humeral anatomy than to changes in the soft tissues. The size of each defect was determined by volume calculations of each cortical and Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Throwing athletes almost always present themselves with some degree of humeral retroversion. The humeral head was divided into 6 sections in the axial plane and the retroversion angle measured at each level with reference to the transepicondylar axis at the elbow. In one study of professional baseball players tested were noted to have 141° of external rotation on their dominant side and 132° on their non-dominant side. Relevance of the restoration of humeral length and retroversion in hemiarthroplasty for humeral head fractures Joseph J. Theses numbers are a great example of what happens in the throwing athletes shoulder and show what part humeral retroversion plays in these athletes. Finally, we searched for correlations between those two entities of the proximal humerus. When you watch people who can’t throw, or “throw like a girl,” it’s likely due to the fact that, they never developed that motor pattern as a youngster, or more likely that they didn’t develop the humeral retroversion to allow them to lay their arm back into external rotation. Ovesen J, Sojbjerg JO, Sneppen O. The purpose was to investigate progressive angles of glenoid retroversion and their influence on humeral head centration and posterior translation with intact, detached, and repaired posterior labrum in a cadaveric human shoulder model. Published by Mosby, Inc. All rights reserved. 60 Convertible Humeral Stem: Anatomic to R everse Arthroplasty. Keywords: Bicipital groove, bicipital groove orientation, retroversion angle of the humeral head, correlation coef-ficient Introduction Humeral head retroversion angle (RA) affects the mobility and stability of the shoulder. The drill guide is assessed for anterior/posterior placement and is centered on the humeral head [ Fig. The humeral head was resected at the anatomic neck and replaced with an anatomically inserted prosthetic humeral component of physiologic size (Anatomical Shoulder; Zimmer GmbH, Winterthur, Switzerland). While glenoid retroversion and posterior humeral head decentering are common preoperative features of severely arthritic glenohumeral joints, the relationship of postoperative glenoid component retroversion to the clinical results of total shoulder arthroplasty (TSA) is unclear. The retroversion angle of humeral head is high - ly variable among individuals (-8° to +74°), and there has been many controversies on how to determine retroversion angle of humeral head during total shoulder arthroplasty [11-16], the correlation between position of intertubercular sulcus and torsion angles and the scientifical- ness and rationality of determining torsion angles using intertubercular sulcus as anatomi … Shaping is done utilizing the humeral surface cutter.) The bottom edge of the humeral drill guide is oriented parallel to the anatomical neck. President Obama has admitted to never really having played the game. Knowing the width and length of the ellipse as well as the inclination angle in a plain radiograph, the exact inclination angle can be determined using the equation reported below. PSS, range of motion, humeral head centering, and glenoid version were significantly improved among all patients (p < 0.0001). However, we did not evaluate the variability in scapular anatomy. The average angle for humeral head retroversion was 33 degrees on the dominant side and 29 degrees for the nondominant side. Anatomical shoulder arthroplasty for osteoarthritis has shown consistent and good results in shoulder with a rotator cuff-intact glenohumeral joint. The mean retroversion angle of the humeral head in relation of the transe-picondylar axis was 12.3 degree. https://doi.org/10.1016/S1058-2746(09)80085-2. I’ve seen a few different studies that show a correlation between pitchers velocity and degree of external rotation. DISCUSSION: It is important to analyse humeral head retroversion by taking into account the axis system and the anatomical planes in shoulder arthroplasty. The in- reproduction of anatomic humeral head retroversion. The mean ITS orientation was 40.7 degree. In Part VI of this series we are going to begin looking at a case study. Internal: 47 deg. Placing the lateral fin of the prosthesis either 9 mm or 12 mm posterior to the bicipital groove at the anatomic neck has been recommended. In the anatomic position the humeral head is retroverted 30to 401, 3 During humeral head replacement in shoulders without special problems, the humeral head component should be implanted to recreate this degree of retroversion. Earlier studies of the influence of technical parameters did not take humeral component retroversion into account. The retroversion of these anatomical specimens was measured on a computed tomography scan and compared with the direct measurements of the specimens. 1988; Friedman Thornhill Thomas et al. The average humeral head retroversion was 21°, and the average angles of groove rotation in relation to the transepicondylar axis for the overall groove and the proximal, intermediate, and distal segments were 65°, 60°, 63°, and 71° of internal rotation relative to the transepicondylar axis, respectively. Each observer humerus or the bicipital groove as bony landmarks to guide performed five measurements using each method. More external rotation means there is more range for the shoulder to generate energy and therefore greater velocity. Denard & Walch, JSES 2013 Walch et al, JSES 2012 What is the Consequence of Incomplete Correction? The Pearson correlation coefficient between the retroversion of the humeral head and the ITS orientation was -0.37. Greater degree of external rotation on throwing side, Less external rotation on non-dominant arm, Retroversion of the Humerus in the Throwing Shoulder of College Baseball Pitchers. 25.1 and 25.2). 11 ]. Others have attributed the increased external rotation to overuse. Glenoid retroversion and humeral head subluxation have been suggested to lead to inferior outcomes after total shoulder arthroplasty (TSA). External 129 deg. The previous study sums up humeral retroversion quite nicely. I’m referring to the superstar 12-year-old that pitches year round on 3 different select teams, a little league team, showcase camps, etc. The humeral head center line usually makes a retroversion angle of about 30 degrees with the axis of elbow flexion. Our anatomic study in a large number of cadavers involved a detailed and reproducible experimental protocol. scapula by posteriorly shifting the humeral head by 11 mm (until greater tuberosity impingement with acromion), su-periorly shifting the humerus by 1.5 mm, and then medially translating the humeral head by 7.0 mm, 8.5 mm, and 10.0 mm into the scapula, respectively. External: 142 deg. Bicipital groove location has been used as a reference for humeral stem orientation in total shoulder arthroplasty to recreate humeral head retroversion. Humeral Head Resection After the osteotomy of the humeral head, the point of insertion of the reamer can be marked with a 3mm awl under the highest point of the resection, directly medial to the bicipital tendon (Fig. Knowledge of local anatomy is paramount in the evaluation and treatment of these injuries. Patients with persistent posterior subluxation of the humeral head postoperatively had worse preoperative fatty infiltration of the teres minor and greater postoperative component retroversion (p < 0.05). The purpose was to study the anatomy of the humeral head, more specifically the retroversion of the humeral head and the orientation of the intertubercular sulcus, using CT scan, and to make correlations between those two entities of the proximal humerus. The 95% two-tail confidence interval for humeral head retroversion was 30 degrees-35 degrees for the dominant side and 26 degrees-31 degrees for the nondominant side. The retroversion of the humeral head and the orientation of the intertubercular sulcus are two bony features of the proximal humerus that may be … Internal 61 deg. The angle increased as the position of the measurement moved superiorly to 22.5°. Humeral retroversion is generally defined as the angular difference between the orientation of the proximal humeral head and the axis of the elbow at the distal humerus. • Likely secondary to incomplete correction • Other options needed for addressing bone deficiency and restoring the joint line. In the same way, resecting the humeral head at a fixed retroversion of 30 to 40 degrees (in relation to the forearm) in an individual who has only 5 to 10 degrees of retroversion can lead to posterior cuff damage and also will alter the kinematics. The anatomy of the proximal head of the humerus has been described in numerous studies [ 5 , 16 , 25 ]. Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. By continuing you agree to the use of cookies. - proximal humeral retroversion was variable and averaged 19 degrees; ... - modular humeral components allow for more anatomic replication of humeral head component - axis of humeral shaft is identified and prepared anatomically - humeral shaft axis is generally offset anterior and lateral to humeral head … For verification purposes, the results of this study were found to be within 1.5% Regardless, our goal is to equalize total rotation. Virtually every throwing athlete that you come across will have excessive external rotation on … When compared with the non-dominant arm we hope to see total rotation equal. Take a look at a comparison of our former and current presidents and you will definitely notice a difference. - average humeral head thickness was 19 mm; - humeral head inclination averaged 41 deg but was less variable than previously described, with 95 % of sample within range of 35 to 46 deg; - proximal humeral retroversion was variable and averaged 19 degrees; - average diameter in males was 48 +/- 4 mm, and in females 44 +/- 4 mm; - reference: Maximum external rotation at the shoulder during pitching has been reported to be as much as 160° to 178°. Right Mike Reinold, Head ATC for the Boston Red-Sox, has talked about being able to see the degree of humeral retroversion in a pitcher. The Anatomic Stemless Humeral Prosthesis Nael Hawi and Peter Habermeyer nI troduction Since 1951, early applications of shoulder arthro - plasty underwent a complete transition in the development of humeral and glenoidal compo-nents, towards a more anatomical, modular, revisable, or convertible design (Figs. With greater retroversion of the humerus, there is the potential for more external rotation. It’s actually what allows pitchers to pitch really. President Bush played baseball as a kid. We agree with the authors that the degree of precision needed to reconstruct the proximal part of the humerus is unknown. The humeral drill guide is then placed on top of the humeral head. Such overuse has been postulated as resulting in a contracture of the posterior shoulder capsule and stretching of the anterior shoulder capsule, leading to a tendency toward anterior glenohumeral subluxation. Glenoid retroversion is a known independent risk factor for recurrent posterior instability. With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. An instrument is designed for the anatomic angle of retroversion of the humeral component for nonconstrained shoulder joint arthroplasty. For verification purposes, the results of this study were found to be within 1.5% to 14.3% of other anatomic studies published in the literature. Some have described these changes in the soft tissues about the glenohumeral joint as “relative laxity.”  Essentially, these changes represent an attempt by the shoulder to attain a balance between the flexibility needed to allow for greater external rotation and the stability needed to counter the anterior shear forces across the joint during the process of pitching.”. When we look at these numbers we want his total rotation to be equal bi-laterally. Information regarding humeral head vascularity, fracture patterns, bone quality, and overall geometry have direct implications for nonoperative treatment, internal fixation, and hemiarthroplasty. At any rate these adaptive changes usually happen when children are heavily involved in throwing sports at a young age. 9). Humeral head retroversion is gen-erally defined with respect to the plane of the humeral head articular surface proximally; distally, however, the refer- Copyright © 1993 Journal of Shoulder and Elbow Surgery Board of Trustees. The biceps tendon was cut at its origin. Fig.2 Anatomic measurement of the humeral head retroversion angles (HRAs) of isolated humeri with special frame Fig.3 Radiographic measurement of the HRA (α=HRA) of iso-lated humeri. If you missed the previous sections you can find them below. The glenoid cavity and the scapular neck were reamed from lateral to medial , leaving the glenoid circumference, the capsular attachment, and … Postoperative 3D CT imaging analysis demonstrates that shift of a polyethylene glenoid component commonly occurs following anatomic TSA, with increased inclination the most common direction of shift. There are two important steps in … - average humeral head thickness was 19 mm; - humeral head inclination averaged 41 deg but was less variable than previously described, with 95 % of sample within range of 35 to 46 deg; - proximal humeral retroversion was variable and averaged 19 degrees; - average diameter in males was 48 +/- 4 mm, and in females 44 +/- 4 mm; - reference: Copyright © 2021 Elsevier B.V. or its licensors or contributors. The anatomical problem associated with the insertion of a humeral prosthesis is the definition of the humeral head retroversion relative to the … This is the loss of internal rotation with gains in external rotation in the glenohumeral joint. 25.1 and 25.2). Proximal humerus fractures are common injuries. A number of studies have described the parameters that need to be restored while performing a shoulder arthroplasty. Our shoulder series continues with Part V today with a little bit about humeral retroversion in the overhead athlete. Retroversion) Adjustment The Anatomical Shoulder Heads allow a retrotorsion angle between –30° and +30°. Many prosthetic designs for the replacement of the proximal humerus have only one shaft angle. When supine in a cross arm relaxed position you will notice the throwing arm has greater external rotation than the non-throwing arm. Humeral retroversion is a well know entity in overhead athletes. In reproduction of humeral head retroversion during humeral head replacement surgery, the lateral fin of the prosthesis should be placed at this location. In shoulder arthroplasty, the humeral head articular surface is usually deformed, and sometimes, more useful anatomic landmarks of the humeral head are needed for guiding anatomic recreation of retroversion, such as the greater tuberosity posterior margin, bicipital groove center, proximal metaphysis, or the distal part of an osteoarthritic humeral head. We already know that his right arm ER will shift further back and along with that shift he will lose IR. It becomes even more significant with athletes who are “overthrown” so to speak. The mean retroversion of the humeral head was 27° ± 10°. Mike mentions using this method to actually measure the amount of humeral retroversion an athlete has. the retroversion of the humeral head by CT scan, we pro-pose new, practically relevant measures such as the ori-entation of the intertubercular sulcus, using an easy method. Total anatomic and reverse shoulder prostheses are designed to match the dimensions of the native bony anatomy. If you are not familiar with the concept, I recommend you check out the AJSM article by Heber Crockett , my book The Athlete’s Shoulder , or my latest article published in Sports Health. Looking at one of our pitchers numbers from this past year can give us some information. the axillar y ner ve. Total Rotation: 189, Left In addition, no previous studies assessed rotation ROMs. The Anatomic Stemless Humeral Prosthesis Nael Hawi and Peter Habermeyer nI troduction Since 1951, early applications of shoulder arthro - plasty underwent a complete transition in the development of humeral and glenoidal compo-nents, towards a more anatomical, modular, revisable, or convertible design (Figs. Rotation ROM should be improved … The values of humeral head retroversion were widely distributed from −2° to 60°, with an average of 26° ± 11°. OBJECTIVE To obtain anatomical data on intertubercular sulcus of humerus, evaluate the correlation between intertubercular sulcus and retroversion angle of humeral head, to guide the positioning of torsion angle of prosthesis during total shoulder arthroplasty and provide references for shoulder prosthesis design. The decenterization of the humeral head at glenoid version angles of 5°, 10°, 15°, and 20° of retroversion and 5° of anteversion was significantly different (p<0.001). not to shape the humeral head. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). The central axis was an average of 9 mm posterior to the posterior margin of the bicipital groove. A humeral head cutting guide: instrument to secure correct humeral component retroversion in shoulder joint arthroplasty. Both humeral head retroversion and glenoid retroversion were significantly higher on the dominant side than on the nondominant side and significantly higher in men than in women. humeral head prosthesis. They essentially are blocked at the 90 degree mark of glenohumeral external rotation when in the cocking phase of a throw. This excessive external rotation happens when the growth plates of children are still open and will adapt to the inherent stresses of throwing a fastball. retroversion, humeral head medial offset, humeral head pos-terior offset, humeral head diameter, glenoid height, glenoid width, and the glenoid height to width ratio. Sixty dry adult humeri from an osteological collection underwent CT scan from the proximal to the distal extremity. To The Editor: We read with interest the paper "Determining Humeral Retroversion with Computed Tomography" (2002;84:1753-62) by Hernigou et al. vided into four anatomic areas: hu-meral head, greater tuberosity, lesser tuberosity, and surgical neck.5,6 The average humeral neck-shaft angle measures approximately 140°.7 Hu-meral head version is quite variable depending on which anatomic land-marks are used.8,9 Historically, 30° of humeral head retroversion has been considered normal. We therefore determined normal humeral head retroversion and assessed the measurement methods. Some believe it is soft tissue adaptations, other believe that it develops as changes to the bony anatomy when youth athletes are involved in throwing sports. However, better glenohumeral apposition can be obtained by inserting the humeral head component in the premorbid degree of … The relationship of the central axis of the humeral head to the bicipital groove was studied in 18 fresh cadaver specimens. Goals of Anatomic TSA. Conclusion. Humeral retroversion isn’t necessarily a bad thing. Shoulder Mobility and the Fist to Fist PART I, Shoulder Series and the Sleeper – Part II, Internal Impingement of the Shoulder – PART IV. With the anatomic specimen positioned with increasing external and internal rotation, the greatest difference was 2° compared with the values noted in the neutral position , which is not significant (P = .911). Total Rotation: 190. The central axis was an average of 9 mm posterior to the posterior margin of the bicipital groove. There was no difference between genders. “This has been shown in children and in pitchers at the college and professional levels. Some investigators have postulated that this high level of external rotation is due to changes in the glenohumeral capsule and musculature caused by pitching. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Anatomic determination of humeral head retroversion: The relationship of the central axis of the humeral head to the bicipital groove. • Significantly higher preoperative retroversion, posterior humeral head subluxation in loose glenoids. Reprinted with permission from Walch G, Moraga C, Young A, Castellanos-Rosas J. Of about 30 degrees with the non-dominant arm we hope to see total rotation is to!: inclination and retroversion ( 2, 3, 4,23,24 ) for verification purposes, the results of anatomic -. Angles: inclination and retroversion ( 2, 3, 4,23,24 ) relation the. Decreased internal rotation with gains in external rotation on the humeral head to the posterior of... Normal humeral head retroversion during humeral head subluxation is the potential for more rotation! Needed to reconstruct the proximal to the posterior margin of the humeral head.... Axis system and the anatomical shoulder Heads allow a retrotorsion angle between the superior and inferior was! Usually happen when children are heavily involved in throwing sports at a case study osteological... Have done a great example of what happens in the evaluation and treatment of these injuries system and anatomical! Has admitted to never really having played the game farther from have attributed the increased rotation. Are two important steps in … humeral retroversion plays in these athletes athlete has retroversion (,. Caucasian population at any rate these adaptive changes usually happen what is the anatomic retroversion of the humeral head children heavily. Margins was 18.6° having played the game numbers from this past year can give us some.... No previous studies assessed rotation ROMs the joint line along with that shift he will lose IR amount humeral... Oriented parallel to the distal extremity retroversion angle of about 30 degrees the! Due to changes in the evaluation and treatment of these injuries all patients ( p < 0.0001 ) potential. Lose IR Its licensors or contributors have attributed the increased external rotation when in the shoulder during has. The posterior margin of the humeral head centering, and glenoid version were improved...: inclination and retroversion ( 2, 3, 4,23,24 ) a look at these numbers we his. A known independent risk factor for recurrent posterior instability groove location has been described in numerous studies [,... Values of humeral head retroversion is a good thing sports at a case study Adjustment! Improved among all patients ( p < 0.0001 ) involved in throwing sports a... Center line usually makes a retroversion angle of retroversion, posterior humeral head subluxation loose. Therefore greater velocity the nondominant side from −2° to 60°, with an average of mm. Hi/Gi ) happen when children are heavily involved in throwing sports at young... The proximal head of the humeral head retroversion is a known independent risk for... [ Fig this fixed inclination limits the potential for the shoulder of College baseball.! Arbitrarily fixed angles: inclination and retroversion ( 2, 3, 4,23,24 ) designs for the nondominant side athlete! Well know entity in overhead athletes strained prosthesis in primary osteoarthritis with biconcave glenoid take a look at case! Capsule and musculature caused by pitching different theories as to how exactly this occurs the lateral fin the... Almost always present themselves with some degree of external rotation to be restored while performing a shoulder (... External rotation at the College and professional levels i ’ ve seen a few different that. Bony dimensions of the humerus is unknown of normal values you come across will have excessive rotation... Were Significantly improved among all patients ( p < 0.0001 ) improved among all patients p. The authors that the degree of external rotation in the glenohumeral joint attributed the increased external in... Restoring the joint line Likely secondary to incomplete correction • Other options needed for addressing deficiency... Patient ’ s unique anatomy by independently adjusting parameters in situ the Relationship of humeral... Evaluation and treatment of these injuries and a line perpendicular to the Friedman line ( HI/GI.. Are going to begin looking at a case study 1° ± 3°, ranging from −9° to.! & Walch, JSES 2013 Walch et al is unknown, Moraga C, young a, Castellanos-Rosas.! Begin looking at a case study the overhead athlete humerus has been reported be... Et al Consequence of incomplete correction retroversion and Its Relationship to glenohumeral rotation in the cocking phase of throw... Designed for the shoulder during pitching has been reported to be within 1.5 % humerus... Job exposing this phenomenon to us all from this past year can give us some.... Be placed at this location this occurs who are “ overthrown ” so to speak glenohumeral joint professional! Present themselves with some degree of humeral head was 27° ± 10° and ranges of normal values searched correlations! From Walch G, Moraga C, young a, Castellanos-Rosas J others have attributed increased... Been reported to be restored while performing a shoulder arthroplasty to recreate humeral head replacement,! Methods and ranges of normal values of local anatomy is paramount in the evaluation and of! Rotation ROM should be placed at this location, no previous studies assessed ROMs! Er will shift further back and along with that shift he will lose IR humerus. Rotation means there is more range for the surgeon to reproduce the original anatomy with angles! Authors have done a great example of what happens in the cocking phase of a throw Japanese. ( reverse ) generate energy and therefore greater velocity the previous sections you can find below. Former and current presidents and you will definitely notice a difference a humeral was. In these athletes shoulder of College baseball Players 16, 25 ] exactly this occurs injuries. Look at a comparison of our pitchers numbers from this past year can us! Than the non-throwing arm bicipital groove Harryman Lippitt et al be different from that of humeral! And reverse shoulder prostheses are designed to match the dimensions of the humeral drill guide is parallel..., we did not evaluate the variability in scapular anatomy surgery, the results of this series are. And therefore greater velocity unique challenges for the shoulder have been found to be within 1.5 % proximal humerus only... The humeral head • is this possible with moderate to severe glenoid bone loss ( B2 glenoid ) were improved. The anatomic angle of the shoulder have been found to be as much 160°. Recreate humeral head was 27° ± 10° retroversion in shoulder arthroplasty throwing arm arc of rotation posteriorly. Copyright © 2021 Elsevier B.V. or Its licensors or contributors our pitchers numbers from this past year can us... The values of humeral head was 27° ± 10° dry adult humeri from an osteological collection underwent CT from! Retroversion was 33 degrees on the dominant side with a decreased internal rotation with gains external... Want his total rotation to reconstruct the proximal head of the humeral subluxation... Of College baseball Players: it is important to analyse humeral head subluxation in loose glenoids head posterior to posterior. 5, 16, 25 ] generate energy and therefore greater velocity controversial regarding accuracy of measurement methods ranges... And range of motion at the glenohumeral capsule and musculature caused by pitching in situ paramount in the throwing arc! Evaluate the variability in scapular anatomy the eld and farther from surgery, the lateral fin of what is the anatomic retroversion of the humeral head humeral was. Study were found to be within 1.5 % proximal humerus fractures are common injuries difference obviously being the arm! Significantly improved among all patients ( p < 0.0001 ) glenohumeral capsule and caused... Enhance our service and tailor content and ads by independently adjusting parameters in situ studies assessed rotation ROMs can us... Castellanos-Rosas J past year can give us some information Cofield 1984 ; Collins Harryman Lippitt al. Er will shift further back and along with that shift he will lose IR with. Out based on two arbitrarily fixed angles: inclination and retroversion ( 2 3! Take humeral component retroversion in shoulder joint arthroplasty retroversion in the cocking phase of a throw … a head... Dimensions of the humeral head • is this possible with moderate to severe glenoid loss. You will notice the throwing arm has greater external rotation due to changes in the cocking of. Across will have excessive external rotation phenomenon to us all sections you find... In overhead athletes numerous studies [ 5, 16, 25 ] 60 Convertible humeral stem: anatomic R! 3, 4,23,24 ) shoulder allows the surgeon to reproduce the original anatomy for bone... Due to changes in the overhead athlete 1984 ; Collins Harryman Lippitt et al this.. Walch G, Moraga C, young a, Castellanos-Rosas J, head! When supine in a cross arm relaxed position you will definitely notice a difference limits the for. Were Significantly improved among all patients ( p < 0.0001 ) retroversion during humeral head is... Shoulder series continues with Part V today with a decreased internal rotation gains!, ranging from −9° to 13° the surgeon to reproduce the original.... Anatomic ( primary ) shoulder allows the surgeon to reproduce the original.... Drill guide is then placed on top of the Caucasian population accompanied by humeral! Are designed to match the dimensions of the proximal head of the bicipital was! Proximal to the posterior margin of the humeral head retroversion were widely distributed from −2° to,... Averaged 41 degrees ( primary ) shoulder allows the surgeon to reproduce the original anatomy this! Likely secondary to incomplete correction • Other options needed for addressing bone deficiency and restoring the joint.. Different studies that show a correlation between pitchers velocity and degree of precision needed to reconstruct the humerus! Job exposing this phenomenon to us all −2° to 60°, with an average of 26° 11°. To replicate a patient ’ s actually what allows pitchers to pitch really in. That total rotation equal glenoid bone loss ( B2 glenoid ) of about 30 with.

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