Caput Humeri’nin Anatomik Değerlendirmesi ve Omuz Artroplastisi Üzerindeki Klinik Önemi

Abstract

Omuz artroplasti cerrahisi, birçok patolojinin tedavisinde omuz eklemi fonksiyonunu geri kazandırmak için sıklıkla uygulanmaktadır. Omuz artroplasti cerrahisinin sonuçlarını iyileştirmek için omuz protez bileşenlerinin tasarımında caput humeri’nin morfolojisi dikkate alınmalıdır. Bu nedenle, bu çalışma omuz artroplastisinde kullanılan protez bileşenlerinin doğru boyutlarını belirlemek amacıyla caput humeri morfometrisini değerlendirmek amacıyla yapıldı. Bu çalışmada, yaşı ve cinsiyeti bilinmeyen 101 insan kuru humerus kemiği (52 sağ, 49 sol taraf) incelendi. Humerus boyu, caput humeri’nin vertikal ve transvers çapı, caput humeri’nin yüksekliği ve caput humeri’nin en yüksek noktası ile tuberculum majus arasındaki mesafe değerlendirildi. Humerus boyu ortalama 31,05 ± 2,01 cm olarak ölçüldü. Caput humeri’nin ortalama vertikal çapı 43,64 ± 3,79 mm, transvers çapı ise 39,17 ± 3,35 mm olarak bulundu. Bu çalışmanın bulguları, caput humeri’nin şeklinin küresel olmaktan ziyade elips şeklinde olduğunu gösterdi. Caput humeri’nin yüksekliği 19,49 ± 2,97 mm olarak ölçüldü. İki taraf arasında caput humeri’nin yüksekliğinde istatistiksel olarak anlamlı fark gözlemlendi (p<0,001). Caput humeri’nin en yüksek noktası ile tuberculum majus arasındaki mesafe 6,79 ± 1,53 mm olarak bulundu. Bu çalışmanın bulguları, caput humeri ile ilgili diğer anatomik çalışmaların sonuçlarıyla uyumluydu. Bu çalışmada elde edilen sonuçlar, gelecekteki omuz protez sistemlerinin tasarımında yol gösterici olacaktır.

Keywords

• Caput humeri çapı
• caput humeri yüksekliği
• morfometri
• omuz artroplastisi

Anatomical Evaluation of Humeral Head with its Clinical Importance on Shoulder Arthroplasty

Abstract

Shoulder arthroplasty surgery is frequently performed to restore shoulder joint function in many pathologies. The morphology of the humeral head should be considered in the design of the shoulder prosthetic components to improve outcomes of shoulder arthroplasty surgery. Therefore, this study aimed to evaluate the morphometry of the humeral head in order to determine the correct dimensions of the prosthetic components used in shoulder arthroplasty. The present study examined 101 human dry humeri (52 right, 49 left sides) of unknown age and sex. Humerus length, vertical and transverse diameter of humeral head, height of humeral head and distance between the highest point of the humeral head and greater tubercle were evaluated. The mean humerus length was measured 31.05 ± 2.01 cm. The mean vertical diameter of the humeral head was found to be 43.64 ± 3.79 mm, and the transverse diameter was measured as 39.17 ± 3.35 mm. The findings of the present study indicate that the shape of the humeral head is elliptical rather than spherical. The height of the humeral head was measured at 19.49 ± 2.97 mm. A statistically significant discrepancy was observed in the height of humeral head between the two sides (p<0.001). The distance between the highest point of the humeral head and the greater tubercle was found to be 6.79 ± 1.53 mm. The findings of this study were in concordance with the results of other anatomical investigations of the humeral head. The results of the present study have the potential for application in the design of future prosthetic shoulder systems.

Keywords

• Humeral head diameter
• humeral head height
• morphometry
• shoulder arthroplasty

References

1. 1. Pearl ML. Proximal humeral anatomy in shoulder arthroplasty:Implications for prosthetic design and surgical technique. J Shoulder Elbow Surg. 2005;14(1 Suppl S):99-104. doi:10.1016/j.jse.2004.09.025.
2. 2. Inyang AO, Roche S, Sivarasu S. An interpopulationcomparison of 3-dimensional morphometric measurements ofthe proximal humerus. JSES Int. 2020;4(3):453-463. doi:10.1016/j.jseint.2020.03.003.
3. 3. Cohn MR, Austin LS, Williams GR, Abboud JA. Ellipticalhumeral head implants in anatomic total shoulder arthroplasty. J Am Acad Orthop Surg. 2023;1;31(21):1112-1119. doi:10.5435/JAAOS-D-22-01084.
4. 4. Aydin Kabakci A, Buyukmumcu M, Yilmaz M, Cicekcibasi A,Akın D, Cihan E. An osteometric study on humerus. Int. J.Morphol. 2017;35(1):219-226. doi:10.4067/S0717-95022017000100036.
5. 5. Akman ŞD, Karakaş P, Bozkir MG. The morphometric measurements of humerus segments. Turk J Med Sci. 2006;36(2):81-85.
6. 6. Suroto H, Licindo D, Wibowo P, et al. Morphology of humeralhead and glenoid in normal shoulder of indonesian population. Orthop Res Rev. 2022;14:459-469. doi:10.2147/ORR.S378658
7. 7. Humphrey CS, Sears BW, Curtin MJ. An anthropometricanalysis to derive formulae for calculating the dimensions ofanatomically shaped humeral heads. J Shoulder Elbow Surg. 2016;25(9):1532-41. doi:10.1016/j.jse.2016.01.032.
8. 8. Le TGA, Phan NT, Nguyen PD. Anatomical morphometry ofthe proximal humerus in the Vietnamese population: Acomparative study using multiplanar computed tomography andcadaveric dissection. J Hand Microsurg. 2025;17(4):100294. doi:10.1016/j.jham.2025.100294.

9. 9. Heifner JJ, Pertierra G, Vegas AT, Rowland RJ, Mercer DM,Orbay JL. Morphometry of the proximal humerus and therelationship to global offset. Seminars in Arthroplasty 2024:907-914. doi.org/10.1053/j.sart.2024.07.005.
10. 10. Vatansever A, Babacan S, Gülşen K, Çetin G, Karakılıç MR. Prediction of proximal humerus morphometric characteristicsfor patient-specific humerus prosthesis design. Journal ofUludağ University Medical Faculty. 2025;51(1):81-86. doi.org/10.32708/uutfd.1652561.
11. 11. Terrier A, Ramondetti S, Merlini F, Pioletti DD, Farron A.Biomechanical consequences of humeral componentmalpositioning after anatomical total shoulder arthroplasty. J Shoulder Elbow Surg. 2010;19(8):1184-90. doi:10.1016/j.jse.2010.06.006.
12. 12. Youderian AR, Ricchetti ET, Drews M, Iannotti JP.Determination of humeral head size in anatomic shoulderreplacement for glenohumeral osteoarthritis. J Shoulder ElbowSurg. 2014;23(7):955-63. doi:10.1016/j.jse.2013.09.005.
13. 13. Pearl ML, Kurutz S, Postacchini R. Geometric variables inanatomic replacement of the proximal humerus: how muchprosthetic geometry is necessary? J Shoulder Elbow Surg. 2009;18(3):366-70. doi:10.1016/j.jse.2009.01.011.
14. 14. Williams GR, Jr., Wong KL, Pepe MD, et al. The effect of articular malposition after total shoulder arthroplasty onglenohumeral translations, range of motion, and subacromialimpingement. J Shoulder Elbow Surg. 2001;10(5):399-409. doi:10.1067/mse.2001.116871.
15. 15. Kaar SG, Fening SD, Jones MH, Colbrunn RW, Miniaci A.Effect of humeral head defect size on glenohumeral stability: acadaveric study of simulated Hill-Sachs defects. Am J SportsMed. 2010;38(3):594-9. doi:10.1177/0363546509350295.
16. 16. Sahu D, Joshi M, Rathod V, Nathani P, Valavi AS, Jagiasi JD.Geometric analysis of the humeral head and glenoid in theIndian population and its clinical significance. JSES Int. Dec2020;4(4):992-1001. doi:10.1016/j.jseint.2020.06.008.
17. 17. Iannotti JP, Jun BJ, Teplensky J, Ricchetti E. Humeral headshape in native and prosthetic joint replacement. J Shoulder Elb Arthroplast. 2019;3:2471549219848150.doi:10.1177/2471549219848150.
18. 18. Pearl ML, Volk AG. Coronal plane geometry of the proximalhumerus relevant to prosthetic arthroplasty. J Shoulder ElbowSurg. 1996;5(4):320-6. doi:10.1016/s1058-2746(96)80060-7.