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Total Shoulder Arthroplasty – Landmarks & Measurements Guidelines

This document defines the anatomical landmarks and measurements used during preoperative planning and postoperative surgical planning for total shoulder procedures.

Updated over a month ago

Shoulder – Total Shoulder Arthroplasty (Anatomic / Reverse)


All landmarks and measurements are derived from patient imaging and are intended to support planning, verification, and communication, not automated clinical decision-making.


Preoperative Landmarks – Scapula

Scapular Axis

  • Stage: Pre

  • Type: Landmark

  • Bone: Scapula

  • Description:
    A line defined from the center of the glenoid surface to the trigonum scapulae.
    This axis serves as the primary anatomical reference for glenoid orientation measurements.


Glenoid Plane

  • Stage: Pre

  • Type: Landmark

  • Bone: Scapula

  • Description:
    A plane parallel to the native glenoid rim, explicitly excluding osteophytes, representing the true articular surface of the glenoid.


Inferior Angle of the Scapula

  • Stage: Pre

  • Type: Landmark

  • Bone: Scapula

  • Description:
    The most inferior anatomical point of the scapula, used to support consistent definition of the scapular anatomical orientation.


Preoperative Measurements – Scapula

Glenoid Inclination

  • Stage: Pre

  • Type: Measurement

  • Bone: Scapula

  • Description:
    The angle between the scapular anatomical axis and the glenoid surface measured in the coronal scapular plane.


Glenoid Version

  • Stage: Pre

  • Type: Measurement

  • Bone: Scapula

  • Description:
    The angle between the scapular anatomical axis and the glenoid surface measured in the axial scapular plane.


Postoperative / Surgical Plan Measurements – Scapula

Planned Inclination

  • Stage: Post

  • Type: Measurement

  • Bone: Scapula

  • Description:
    The angle between the scapular anatomical axis and the central K-wire axis measured in the coronal scapular plane, reflecting the planned implant orientation.


Planned Version

  • Stage: Post

  • Type: Measurement

  • Bone: Scapula

  • Description:
    The angle between the scapular anatomical axis and the central K-wire axis measured in the axial scapular plane.


Screw Length – Central

  • Stage: Post

  • Type: Measurement

  • Bone: Scapula

  • Description:
    The maximum potential depth of the central screw based on planned implant trajectory and available bone stock.


Baseplate Entry Points

  • Stage: Post

  • Type: Measurement

  • Bone: Scapula

  • Description:
    Defined anterior and inferior baseplate entry points, positioned at 90° from the baseplate center, used for planning fixation screw trajectories.


Screw Length (Bone Contact)

  • Stage: Post

  • Type: Measurement

  • Bone: Scapula

  • Description:
    The portion of the screw length that remains in direct contact with bone, excluding non-engaged sections.


Preoperative Landmarks – Humerus

Humeral Anatomical Axis

  • Stage: Pre

  • Type: Landmark

  • Bone: Humerus

  • Description:
    A line passing through the center of the humeral shaft, extending from distal to proximal, representing the humeral anatomical reference axis.


Humeral Neck Plane

  • Stage: Pre

  • Type: Landmark

  • Bone: Humerus

  • Description:
    The native head–neck plane of the humerus, representing the patient’s current humeral version.


Preoperative Measurements – Humerus

Neck–Shaft Angle

  • Stage: Pre

  • Type: Measurement

  • Bone: Humerus

  • Description:
    The angle between the humeral neck plane and the humeral anatomical axis.


Postoperative / Surgical Plan Measurements – Humerus

Planned Neck–Shaft Angle

  • Stage: Post

  • Type: Measurement

  • Bone: Humerus

  • Description:
    The angle between the humeral anatomical axis and the planned cutting plane.


Planned Humeral Version

  • Stage: Post

  • Type: Measurement

  • Bone: Humerus

  • Description:
    The angular difference between the native humeral neck plane and the planned cutting plane.


Humeral Cut Height (Perpendicular)

  • Stage: Post

  • Type: Measurement

  • Bone: Humerus

  • Description:
    The distance from the cutting plane to the humeral head, measured perpendicular to the cutting plane.


Humeral Cut Height (Axial)

  • Stage: Post

  • Type: Measurement

  • Bone: Humerus

  • Description:
    The distance from the cutting plane to the humeral head, measured parallel to the humeral anatomical axis.


Postoperative Landmarks – Humerus

Cutting Plane

  • Stage: Post

  • Type: Landmark

  • Bone: Humerus

  • Description:
    A plane coincident with the humeral stem axis, defining the final humeral resection level for implant placement.


Notes & Best Practices

  • All landmarks must be reviewed and approved by the clinician prior to final plan approval.

  • Osteophytes should be excluded when defining native anatomical reference planes.

  • Measurements are provided for planning and verification purposes only and must be clinically validated by the surgeon.

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