By P. Sobota. University of Mary Washington. 2018.
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The CT scan revealed numerous anatomic changes generic aldactone 25 mg amex, more pronounced on the posterior margin of the glenoid effective 25 mg aldactone. Two subgroups were identified: B1 (17%) showed narrowing of the posterior joint space, subchondral sclerosis, and osteophytes, and B2 (15%) demon- strated a posterior cupula that gave an unusual biconcave aspect of the glenoid. In type B2, there was an excessive retroversion of the glenoid according to Friedman et al. The retroversion was of dysplastic origin, and the humeral head was well centred or slightly subluxated posteriorly. An index between 45 and 55% represents a centred humeral head, 0% is an anterior dislocation, and 100% is a posterior dislocation. An index of more than 55% indicates posterior subluxation and below 45% indicates anterior subluxation 13. In this investigation the coracoid baseline is reproducible because the ap-view is taken into a standardized standing position of the patient, so that the inferior border of the X-ray film is parallel to the bottom and the lateral base of the coracoid does not change with rotation of the sca- pula. The bony ele- ments not affected by the lysis do not undergo any modification in their shape, for example, the greater tuberosity is not eroded and the acromion does not have a humeral head imprint. Lysis of either the humeral head or the acromion 160 13 Classifications of Osteoarthritis of the shoulder There was no age difference between the three groups. The acromio-hu- meral joint space narrowing was significantly greater in group 1 than in group 3 and 2. Four distinct groups have been formed on the basis of the biomechanics and clinical out- comes of arthroplasty. The four types are distinguished by the degree of superior migration from the centre of rotation and the amount of insta- bility of the centre of rotation. This classification (Table 5) has proposed benefits in surgical decision-making for optimal implant type, goals of reconstruction, and outcomes. These were based chiefly on the acromiohumeral interval (AHI), which has been considered in the literature to be a sensitive indicator for the full- thickness cuff tear.
