Area-Based Determination of Bone Loss Using the Glenoid Arc Angle

In patients with anterior glenohumeral instability, the most commonly observed osseous defect involves the anterior portion of the inferior glenoid. The amount of glenoid bone loss guides surgical treatment, with progressively larger defects not being amenable to arthroscopic soft-tissue procedures. Currently, there is no universally accepted method of quantifying glenoid bone loss. Two-dimensional area-based methods and 1-dimensional methods of measuring bone loss have both been described but cannot be used interchangeably. The surface area of a glenoid bony defect is a more comprehensive descriptor of its magnitude than the 1-dimensional width of the defect. Calculating surface area can be challenging. We describe a method of quantifying glenoid bone loss using a glenoid arc angle that corresponds to the surface area of the defect. The arc angle is easily measured by use of commonly used imaging software tools and is independent of the size of the glenoid or defect orientation. This method may prove valuable in preoperative planning for patients with anterior glenohumeral instability.