Revisited: Walch Classification of the Glenoid in Glenohumeral Osteoarthritis

Abstract

Background Shoulder osteoarthritis is characterized by progressive wear of the joint. To grade the degree of joint deformity, the Walch classification of glenohumeral arthritis has been proposed. This classification is based on five categories (A1, A2, B1, B2, C), although its validity has been questioned. Methods The present study proposed a new classification in three categories and compared it in terms of inter- and intra-observer reliability with the complete Walch classification and regroup classification (A, B, C). Results One hundred and sixteen computed tomography scans of patients with shoulder arthritis were revised by three independent evaluators and were classified according to the three classifications. The kappa statistics were identical between the new classification and the complete Walch classification (0.87 and 0.874). The regroup Walch classification (A, B, C) demonstrated higher reliability (kappa = 0.92). Most of the disagreement between observers was observed between glenoid B1 and B2. Discussion We report the first study on the Walch classification to use a large number of patients and challenge its reliability. According to the results obtained, there is no advantage in changing the classification. Therefore, surgeons must be aware of higher risk of mistake for glenoid type B. The superiority of a classification in terms of the prediction of surgical decisions and outcome has to be determined.