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Original Article
Anthropometrical study of the human glenoid in a normal Spanish population
Estudio antropométrico de la glena humana en una población española normal
L. Rosales-Rosalesa, A.P. Rosales-Varob,
Corresponding author
aprosalesv@gmail.com

Corresponding author.
, M.A. García-Esponac, O. Roda-Murillod, I. Montesinose, P. Hernandez-Cortésa,b,c,d,e
a Universidad de Granada, Granada, Spain
b Área de Traumatología, Hospital de Torrecárdenas, Almería, Spain
c Área Radiodiagnóstico, Hospital de Torrecárdenas, Almería, Spain
d Departamento de Anatomía, Facultad de Medicina, Universidad de Granada, Granada, Spain
e Departamento de Cirugía, Facultad de Medicina, Universidad de Granada, Granada, Spain
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in which knowledge of native shoulder anatomy is still fundamental&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">3&#44;4</span></a> Nevertheless&#44; to date and unlike other joints&#44; few anthropometric studies are available on which to base changes in prosthetic implants&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">3&#8211;11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Although some shoulder prostheses have been designed for specific populations&#44; they may be too large for the Spanish population&#46; Previous studies<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">12</span></a> compare the morphology of the glenohumeral joint between North America and East Asia&#46; Their results conclude that shoulder morphology is significantly smaller&#44; with some exceptions&#44; in the South East Asia group&#46; Other studies with a similar scope state that the implants available in the market are too large for the Japanese population&#44; especially for the female sex&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">13</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Unfortunately the size of the glenoid in the Spanish population has not been studied&#46; Discovering the actual size of the glenoid in the Spanish population will make it possible to improve the adaptability of the implants in our country and know whether it is necessary to design new components&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">This study has the purpose of evaluating the size of the glenoid in a normal population in the south of Spain&#44; associating it with previous results in other populations and evaluating the implant sizes commercialised for shoulder arthroplasty&#44; to propose whether other glenoid implant sizes should be produced that would be anatomically more suitable for our population&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">We present a descriptive anthropometric study of the glenoid&#46; It is based on computed tomography &#40;CT&#41; scans of the shoulder carried out for any clinical indication &#40;traumatic pathological process&#44; primary arthrosis&#44; cuff involvement&#41;&#44; in the population of Andalusia from January 2015 to December 2017&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The study includes 154 patients&#44; of which 106 &#40;68&#46;83&#37;&#41; were women&#46; The average age of our sample is 66&#46;2 years old&#46; The following inclusion criteria were used for patients&#58; Spanish nationality and born of Spanish parents&#44; born in Andaluc&#237;a of Andalusian parents&#44; aged at least 30 years old and having expressly desired to take part in the study as described by giving their written consent&#46; Patients who were not Spanish nationals or not born of Spanish parents were excluded&#44; as were those with a history of fracture affecting the glenoid cavity&#44; those who carried metallic surgical material that caused image-distorting artefacts&#44; a history of glenohumeral luxations&#44; shoulders that had been operated on even if they were not carriers of osteosynthesis material or metallic implants&#44; obstetric brachial paralysis sequelae or bone dysplasia&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The technique used was based on CT &#40;General Electric HI Light Speed Multislice<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>16 helicoidal CT&#41; of the right and left shoulders&#44; with slices 2<span class="elsevierStyleHsp" style=""></span>mm thick and with 0<span class="elsevierStyleHsp" style=""></span>mm interval between slices&#44; in bone and soft tissue algorithm&#44; with 3D reconstruction &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A study was performed with suppression of the humeral epiphysis and diaphysis for the 3D study of the scapular glenoid surface&#44; on which the transversal and longitudinal axes of the scapular glenoid surface were measured&#46; All of the post-process and humeral disarticulation studies were undertaken by the same radiologist&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Measurements were taken of the length and width of the glenoid in the CT of the same glenoid at 2 moments separated in time &#40;with an interval of from 2 to 3 weeks&#41;&#44; so that recall distortion was minimised&#44; obtaining the definitive figure for both measurements&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The measurements of the glenoid joint surface were made by the same radiologist and orthopaedic surgeon in each one of the patients&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The points of reference for the measurements of the length and breadth of the glenoid joint surface were &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall">The upper point of the glenoid was defined as the top part of the glenoid ovoid&#44; in the supraglenoid tubercle&#44; just below the circumferential edge around the glenoid&#44; understanding this to be periphery of the glenoid joint surface&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">The lower point was defined as the point farthest from the upper point in the outline of the glenoid&#44; above the circumferential edge around the glenoid&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">The anterior and posterior points were defined as the end of the longest transversal axis in a plane perpendicular to the superoinferior axis&#44; within the circumferential edge around the glenoid&#46;</p></li></ul></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">To achieve the study objectives a statistical analysis was undertaken&#44; consisting of&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;1&#41;</span><p id="par0080" class="elsevierStylePara elsevierViewall">A descriptive analysis of each one of the study variables&#44; using frequency distribution for qualitative variables and basic summarised measurements&#44; such as the average&#44; quartiles and standard deviation for quantitative variables&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#40;2&#41;</span><p id="par0085" class="elsevierStylePara elsevierViewall">The intraclass correlation coefficient &#40;ICC&#41; was used to prove the concordance of both measurements by the same subject of the same CT scan at 2 different times&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#40;3&#41;</span><p id="par0090" class="elsevierStylePara elsevierViewall">The averages comparison test was used to analyse the measurements of the glenoid length and width&#44; to compare the men and women in the sample&#46; The fit of a multiple lineal regression model was used to study the association between the measurements of the length and width of the glenoid and the table&#44; as well as sex and age&#46; To measure the power of the relationship between the quantitative variables&#44; Pearson&#8216;s correlation coefficients matrix was calculated for each pair of the said variables&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#40;4&#41;</span><p id="par0095" class="elsevierStylePara elsevierViewall">The univariate reference intervals were calculated for glenoid length and width&#44; under the supposition that both measurements were independent&#44; and then the bivariate reference interval was calculated for both measurements&#44; which are not really independent&#46; The IBM SPSS &#40;v&#46; 20&#46;0&#59; IBM SPSS&#44; Armonk&#44; NY&#44; USA&#41; statistical package was used for all of the statistical tests&#46; An alpha error of 5&#37; was accepted&#44; with a confidence interval of 95&#37;&#44; so that values of <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 were considered to be significant&#46;</p></li></ul></p><p id="par0100" class="elsevierStylePara elsevierViewall">Tests were considered to be statistically significant at 95&#37; level of confidence&#46; The SPSS v&#46; 18 statistical package was used for analysis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0105" class="elsevierStylePara elsevierViewall">The sample consists of 154 glenoids in 154 patients&#44; of which 106 &#40;68&#46;83&#37;&#41; were women and 48 were men &#40;31&#46;17&#37;&#41;&#46; The average age of the total sample is 66&#46;2 years old &#40;the average of the men is 62&#46;5 years old&#44; while that of the women is 67&#46;9 years old&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the results according to the variables of age&#44; height and weight&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">The descriptive measurements of all of the numerical variables in our database for the total sample and the samples of men and women are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#59; this also shows the measurements comparison tests between men and women&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The ages in our sample ranged from 36 years old to 92 years old&#44; giving a broad age range&#46; It may be deduced from comparing the average ages of the sexes that the average age of the women is significantly higher than the average age of the men&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;0110&#46; The average age of the women is higher than that of the men by 5&#46;4 years old&#44; and this shows that in the population from which the sample was extracted&#44; the women are older than the men&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The average height of the women is significantly lower than that of the men &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; showing that in the population from which the sample of women was extracted&#44; they are on average shorter than the men&#46; The same can be said of their weight&#44; as the difference in their average weights amounts to 9&#46;3<span class="elsevierStyleHsp" style=""></span>kg&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">We are able to state that the ICC are quite high for length as well as width&#44; and the intraobserver concordance may be described as very good&#46; More specifically and considering the cut-off points of Landis and Koch&#44; where an ICC above 0&#46;81 is considered to represent almost perfect concordance&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a> we are able to state that the concordance between averages is very good&#44; although it is somewhat better for width than it is for length&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In case the reliability of the measurements may be influenced by sex&#44; the ICC have been shown &#40;in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; for women and men&#44; who are represented in the sample to different degrees&#46; The ICC pattern found in the overall sample for length is less than it is for width&#44; in men as well as in women&#59; nevertheless&#44; the ICC in women are lower &#8211; they are not so good &#8211; as it in the men&#46; But in all cases the ICC are higher&#44; by a large margin&#44; than 0&#46;81&#44; so that we are talking about very high levels of concordance&#46; In any case&#44; the measurements taken have very high values that are sufficient to show their reproducibility or reliability&#44; so that the variability introduced in the sample in our analysis can be ignored&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the values for the variables in both measurements of glenoid length and width&#44; together with the average of both measurements&#46; The length averages in men and in women are significantly different&#46; The average length in men is 30&#46;78<span class="elsevierStyleHsp" style=""></span>mm&#44; and it is 27&#46;87<span class="elsevierStyleHsp" style=""></span>mm in women&#44; i&#46;e&#46;&#44; the longitudinal axis of the glenoid is 2&#46;97<span class="elsevierStyleHsp" style=""></span>mm longer in men&#44; with a confidence interval of 95&#37;&#46; For the width we are able to state that the measurement of the same in men and women is significantly different&#44; as the average width in the men is significantly greater than the average in the women &#40;2&#46;97<span class="elsevierStyleHsp" style=""></span>mm&#41;&#44; with a 95&#37; confidence interval&#58; 2&#46;27&#8211;3&#46;67&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the correlations that have been found to be significantly different from 0 between variables that were of interest&#46; The significant correlations between the height and the glenoid length and width variables deserve attention&#44; as do on the other hand the correlation between the glenoid length and width variables&#46; Both correlations show a positive association between the height variable and the length and width variables&#46; This correlation exists in the sample as a whole &#40;<a class="elsevierStyleCrossRefs" href="#fig0015">Figs&#46; 3 and 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">Only 3&#46;89&#37;&#44; 6 of the patients in the study had a glenoid width of 25<span class="elsevierStyleHsp" style=""></span>mm or more&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The relationship between height and glenoid length exists in the sample as a whole&#44; and it is significant in the sample of women as well as in the sample of men &#40;<a class="elsevierStyleCrossRefs" href="#fig0025">Figs&#46; 5 and 6</a>&#41;&#46; The graphs show the cloud of points that show the relationship between height and each one of the length and width variables&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0155" class="elsevierStylePara elsevierViewall">Although there are several morphometric studies of the glenohumeral joint in different populations&#44; we have not found any such study of the population in the south of Spain&#46; Our study analyses the anthropometrics of the transversal and longitudinal axes of the glenoid cavity by using 3D reconstruction of shoulder CT scans in 154 patients in the south of Spain&#46; The average length of the longitudinal axis was found to be 28&#46;28<span class="elsevierStyleHsp" style=""></span>mm&#44; and the average width was 20&#46;27<span class="elsevierStyleHsp" style=""></span>mm&#46; Significant differences exist between men and women&#44; as the glenoid is larger in men&#46; The length and width of the glenoid in men stand at 30&#46;78<span class="elsevierStyleHsp" style=""></span>mm and 22&#46;32<span class="elsevierStyleHsp" style=""></span>mm&#44; respectively&#44; and at 27&#46;87<span class="elsevierStyleHsp" style=""></span>mm and 19&#46;34<span class="elsevierStyleHsp" style=""></span>mm in women&#46; There is a positive association between the glenoid surface length and width variables&#44; as well as between glenoid size and the height of an individual&#46; This correlation is positive for the total sample&#44; as well as for the samples of men and women&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Several studies have recorded the dimensions of the glenoid joint in the American population&#46; Iannotti et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">6</span></a> analysed glenoid surface dimensions in 140 men&#44; in 44 live subjects and 96 specimens&#46; The measurements in cadavers were taken after removing all of the glenoid soft tissues&#59; the study used MR imaging in the patients&#46; The majority of the subjects in this study were Caucasian&#44; with an average height in both groups of 181<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;9<span class="elsevierStyleHsp" style=""></span>cm for the men and 165<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;1<span class="elsevierStyleHsp" style=""></span>cm for the women&#44; obtaining an average of 39<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5<span class="elsevierStyleHsp" style=""></span>mm in the superoinferior axis and 29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2<span class="elsevierStyleHsp" style=""></span>mm in the lower half of the anteroposterior axis&#44; and 23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;7<span class="elsevierStyleHsp" style=""></span>mm in the upper half&#46; McPherson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">15</span></a> used simple X-rays to measure the length and width of the glenoid in 93 anatomical subjects in South Carolina&#44; obtaining 33&#46;9<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;9<span class="elsevierStyleHsp" style=""></span>mm and 28&#46;6<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;8<span class="elsevierStyleHsp" style=""></span>mm&#44; respectively&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Cabezas et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">16</span></a> studied the morphological differences between 2 populations&#44; one in North America and the other in Eastern Asia&#46; They used 3D computed tomography scans and observed lower morphometric values in the Asian population in comparison with the North American cohort&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Previous publications have compared the morphological data of populations such as those of Thailand<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a> or China<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a> with the North American population&#44; finding larger morphometric sizes in the North American population than was the case in the Asian populations&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Shimozono et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">13</span></a> studied glenoid dimensions in the Japanese population&#44; with 56 shoulders in 55 patients an average age of 63&#46;8 years old&#44; using three dimensional reconstructions of computed tomography scans&#46; The length and width obtained for the Japanese population were 35&#46;8<span class="elsevierStyleHsp" style=""></span>mm and 28&#46;1<span class="elsevierStyleHsp" style=""></span>mm in men&#44; respectively&#44; and 30&#46;8<span class="elsevierStyleHsp" style=""></span>mm and 23<span class="elsevierStyleHsp" style=""></span>mm in women&#44; finding a correlation between the height of an individual and glenoid dimensions&#46; It is striking that the glenoid of the Japanese is larger than that of the Spanish&#46; A possible explanation of this is height&#44; although the average height of the patients included in the study is not specified&#46; Another possible cause is that in our study the reference points for the measurements of glenoid length and width were defined in the internal area of the external edge that circumscribes the glenoid&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Romero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a> evaluated the morphometrics of 61 scapula glenoids of adult individuals in anatomical bone samples in the Anatomy Department of the Central University of Venezuela&#44; obtaining a geometrical average for the cephalocaudal diameter of the glenoid cavity of 3&#46;70<span class="elsevierStyleHsp" style=""></span>cm&#44; and an anteroposterior diameter of 2&#46;71<span class="elsevierStyleHsp" style=""></span>cm&#44; although they did not connect this with either the height or the sex of the individual&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Merill<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">8</span></a> studied the differences in the size and shape of the glenoids of men and women in 363 specimens in the <span class="elsevierStyleItalic">Hamann-Todd</span> osteological collection of Cleveland Natural History Museum&#46; They found a significant difference between the specimens corresponding to men and women&#59; as well as finding rounder glenoids in men and ones that were more oval in women&#44; the average height of the glenoid in men was 37&#46;01<span class="elsevierStyleHsp" style=""></span>mm and 33&#46;83<span class="elsevierStyleHsp" style=""></span>mm in women&#44; while the maximum width was 28&#46;56<span class="elsevierStyleHsp" style=""></span>mm in men and 23&#46;67<span class="elsevierStyleHsp" style=""></span>mm in women&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Matsumura et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">12</span></a> used CT scans to measure the thickness of the humeral head and its diameter as well as the longitudinal and transversal axes of the glenoid surfaces in 160 shoulders of 80 healthy volunteers&#44; with an average age of 30&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9 years old&#44; in a Japanese population with an average height of 173<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;6<span class="elsevierStyleHsp" style=""></span>cm in men and 156<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;3<span class="elsevierStyleHsp" style=""></span>cm in women&#46; The average height of the glenoid in men was 33&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9<span class="elsevierStyleHsp" style=""></span>cm and 29&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7<span class="elsevierStyleHsp" style=""></span>cm in the women&#59; the width was 24&#46;9<span class="elsevierStyleHsp" style=""></span>cm in men and 21&#46;3<span class="elsevierStyleHsp" style=""></span>cm in women&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">The results of our study differ from those published by Americans respecting glenoid size&#46; However&#44; we found that our results are similar to those of studies of the Japanese population&#44; and both populations have smaller glenoid sizes than is the case in America&#46; Contrary to what we expected&#44; the measurements obtained in the Asian population are slightly larger than those in the population in the south of Spain&#46; We found differences between men and women&#44; as did the other authors&#44; with larger dimensions in the men&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Iannotti et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">6</span></a> used magnetic resonance scanning to measure the glenoid surface&#46; Although this techniques offers highly precise images for the study of soft tissues&#44; only intensifies the bone cortex&#46; We used CT scanning&#44; as it offers the maximum definition for study of the bones&#46; Bones are far denser than any other structure around them&#44; except for the density of metal&#44; and due to this the carriers of surgically implanted metal material were excluded&#46; This ensures that there is no artefact whatsoever&#44; and we believe this to be the best technique for studying the bone surface&#46; Other authors such as McPherson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">15</span></a> used simple X-rays&#44; although these techniques are far less precise&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The variations in human height over the decades and between different regions in the world have been studied&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">20</span></a> We are aware of the convergence in height in Spain after the second half of the twentieth century&#44; and in our country the average height of adults in 2003 was 165&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#46; The average height of men stands at 172<span class="elsevierStyleHsp" style=""></span>cm and in women it is 160&#46;1<span class="elsevierStyleHsp" style=""></span>cm&#46; The difference in height distributions between men and women is notable&#59; while more than half &#40;56&#46;57&#37;&#41; of women are no taller than 160<span class="elsevierStyleHsp" style=""></span>cm&#44; 90&#37; of men are taller&#59; likewise&#44; while more than half of men are taller than 170<span class="elsevierStyleHsp" style=""></span>cm&#44; the corresponding group of women amounts to only 6&#46;5&#37; of the female population&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">The average height of the Andalusians &#40;165&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#41; is practically the same as the Spanish average&#46; It is 1<span class="elsevierStyleHsp" style=""></span>cm taller than the shortest inhabitants&#44; those who live in Castile-Le&#243;n &#40;164&#46;4<span class="elsevierStyleHsp" style=""></span>cm&#41; and 2<span class="elsevierStyleHsp" style=""></span>cm shorter than the citizens of the Canary Islands &#40;167&#46;4<span class="elsevierStyleHsp" style=""></span>cm&#41;&#44; who are the tallest Spaniards&#46; Height data according to sex reveal that the fact that the Andalusians are shorter than the national average is due to the women&#44; who are&#44; together with those in Extremadura and Castile-la Mancha&#44; under the height of 160<span class="elsevierStyleHsp" style=""></span>cm&#46; This is not the case for Andalusian men&#44; whose average height &#40;172&#46;2<span class="elsevierStyleHsp" style=""></span>cm&#41; is even above the national average &#40;171&#46;9<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">21</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">The circular metaglenoid inverted prostheses available now in the Spanish market are at least 24&#8211;25<span class="elsevierStyleHsp" style=""></span>mm in diameter&#46; For example&#44; the circular Tornier metaglenoid prosthesis has a diameter of 25<span class="elsevierStyleHsp" style=""></span>mm&#44; while the one by Medcomtech is 24<span class="elsevierStyleHsp" style=""></span>mm in diameter and the one by Depuy is 27<span class="elsevierStyleHsp" style=""></span>mm in diameter&#46; Cylindrical metaglenoid prostheses are also available&#44; such as the one by MBA with a width of 22&#46;8<span class="elsevierStyleHsp" style=""></span>mm&#44; although it is 27&#46;3<span class="elsevierStyleHsp" style=""></span>mm long&#46; Ovoid metaglenoid prostheses can also be found&#44; such as the one by Exactech with a width of 25<span class="elsevierStyleHsp" style=""></span>mm&#44; although it has a longer vertical axis of 33<span class="elsevierStyleHsp" style=""></span>mm&#44; which hinders the technique of implanting it in our patients&#46; The lack of fit between glenoid measurements of the population in the south of Spain and the available implants is evident&#46; This may have clinical implications in the loosening of the glenoid component following shoulder arthroplasty&#44; which is one of the most common causes of revision&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">We found relatively uniform values within both groups&#44; of men and women&#46; Only 6 of the 154 patients included in the study had a glenoid surface width of 25<span class="elsevierStyleHsp" style=""></span>mm or more &#40;3&#46;89&#37;&#41;&#46; The remaining 96&#46;11&#37; would need a smaller prosthesis than the ones available now in the market&#44; thereby preventing prosthesis instability as there is a broad margin without supporting bone in its transversal axis&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Our study suggests that prostheses designed in America are too large for the population in the south of Spain&#46; We believe that our results will be useful to determine the size of prostheses and thereby improve their design&#44; optimising the results of arthroplasty in clinical practice&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Our study has certain limitations&#46; It is possible that there is a bias in selection&#46; Our patients may not be representative of the Spanish population in general&#46; The sample was selected in a population in the south of Spain&#44; so that we are unable to rule out the existence of anthropometric differences in comparison with other populations in the country&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">The sample size may be a limitation of the study&#46; Our sample is composed of 154 patients&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Another possible limitation may be the technique used&#46; CT scans were taken of the shoulder in 2<span class="elsevierStyleHsp" style=""></span>mm thick slices with an interval of 0<span class="elsevierStyleHsp" style=""></span>mm between slices&#44; in bone and soft tissue algorithm&#44; with 3D reconstruction&#46; Thinner slices may show more exact results&#46; In spite of this&#44; we believe that our slices are high precision for the measurements used&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0245" class="elsevierStylePara elsevierViewall">The population in the south of Spain has a smaller glenoid surface size than is the case in the American and similar populations&#44; although it is less than the Asian cohort&#46; The glenoid in our population has an average longitudinal axis of 28&#46;78<span class="elsevierStyleHsp" style=""></span>mm and a width of 20&#46;27<span class="elsevierStyleHsp" style=""></span>mm&#46; Only 3&#46;89&#37; of the population in the south of Spain would be covered by the prostheses currently available in the market&#46; We assume that the majority of patients in our region who are going to be subjected to inverted shoulder arthroplasty will be given an oversized metaglenoid&#46; Although the clinical importance of this has yet to be proven&#44; this should be reason enough to demand the manufacture of smaller prosthesis components&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical aspects</span><p id="par0250" class="elsevierStylePara elsevierViewall">National and international guidelines for biomedical research in human beings were followed during this study &#40;the ethical code and Helsinki declaration&#41;&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">The legal regulations were followed regarding patient data confidentiality&#44; the Spanish Organic Law on personal data protection &#40;Organic Law 15&#47;1999 of 13 December&#41; according to the body controlling compliance with the regulations of the Spanish Data Protection Agency&#46; Patients signed the informed consent document for the study that was carried out&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Level of evidence</span><p id="par0260" class="elsevierStylePara elsevierViewall">Level of evidence III&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interests</span><p id="par0265" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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            0 => "Anthropometry"
            1 => "Glenohumeral joint"
            2 => "Glenoid reverse total shoulder arthroplasty"
            3 => "Metaglenoid"
            4 => "Three-dimensional analysis"
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            0 => "Antropom&#233;trico"
            1 => "Articulaci&#243;n glenohumeral"
            2 => "Pr&#243;tesis invertida de hombro"
            3 => "Metaglena"
            4 => "An&#225;lisis tridimensional"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the size of the glenoid in a southern Spanish population&#44; to compare it with previous results from other populations and determine the size of the implants that are marketed for shoulder arthroplasty&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Between January 2015 and December 2017&#44; an anthropometrical study of the human glenoid was performed using computed axial tomography scans &#40;CT&#41; of 154 patients over 30 years old&#46; The glenoid dimensions were analysed 3-dimensionally using 2<span class="elsevierStyleHsp" style=""></span>mm interval thicknesses&#44; determining the average height and width of the glenoid&#46; The upper point of the glenoid geometry was determined as the supraglenoid tubercle of the ovoid glenoid surface&#44; where the long head of the biceps tendon is thought to originate&#46; The lower point was then positioned at the furthest point from the upper point on the glenoid contour&#46; Anterior and posterior points were determined such that the 3-dimensional anterior&#8211;posterior distance was maximised on the plane perpendicular to the upper&#8211;lower axis&#46; Sex differences and correlations between sides and among the respective parameters in the glenohumeral dimensions were also evaluated&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The glenoid had an average height of 28&#46;78<span class="elsevierStyleHsp" style=""></span>mm and width of 20&#46;27<span class="elsevierStyleHsp" style=""></span>mm&#46; The values were significantly different between the men and the women&#44; being greater in the men&#46; The glenoid size is well correlated with the patient&#39;s size&#46; Direct correlations exist between the glenoid height and width and the glenoid size and the patient&#39;s height&#46; The available metaglenoids currently on the market are no bigger than 25&#8211;24<span class="elsevierStyleHsp" style=""></span>mm&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In comparison&#44; the southern Spanish population have a glenoid size similar to the Caucasian population&#44; but smaller than that of the American population&#46; The data shown could be useful to improve the design of shoulder prostheses for the southern Spanish population&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio es evaluar el tama&#241;o de la glena en una poblaci&#243;n espa&#241;ola normal&#44; compararla con resultados previos en otras poblaciones y relacionarlo con los tama&#241;os de implante que se comercializan para la artroplastia invertida de hombro&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio antropom&#233;trico de la glena humana utilizando tomograf&#237;as computarizadas de 154 pacientes con edades superiores a 30 a&#241;os&#44; realizados entre enero de 2015 y diciembre de 2017&#46; Se valoran tomograf&#237;as computarizadas de hombro con cortes de 2<span class="elsevierStyleHsp" style=""></span>mm de grosor y 0<span class="elsevierStyleHsp" style=""></span>mm de intervalo entre cortes&#44; en algoritmo &#243;seo y de partes blandas&#44; realiz&#225;ndose reconstrucci&#243;n 3<span class="elsevierStyleHsp" style=""></span>D sobre la cual se obtienen mediciones de longitud y anchura de la glena&#46; El punto superior de la glena se determin&#243; en la zona superior del ovoide de la glena&#44; en el tub&#233;rculo supraglenoideo&#44; justo por debajo del reborde circunferencial que rodea la glena&#46; El punto inferior se determin&#243; como el punto m&#225;s alejado del punto superior en el contorno de la glena&#44; a nivel superior del reborde circunferencial que rodea la glena&#46; Los puntos anterior y posterior fueron determinados como los extremos del eje transversal mayor en un plano perpendicular al eje superoinferior&#44; por dentro del reborde circunferencial que rodea la glena&#46; Las diferencias entre sexos&#44; edad&#44; altura&#44; peso y relaciones de tama&#241;os fueron evaluados&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La glena tiene un eje longitudinal medio de 28&#44;78<span class="elsevierStyleHsp" style=""></span>mm y una anchura de 20&#44;27<span class="elsevierStyleHsp" style=""></span>mm&#46; Los valores del tama&#241;o de la glena son significativamente diferentes en hombres y mujeres&#44; siendo mayor en hombres&#46; El tama&#241;o de la glena est&#225; bien correlacionado con la estatura del paciente&#44; existiendo una asociaci&#243;n positiva entre la estatura y la longitud y anchura de la superficie glenoidea&#46; Las metaglenas circulares disponibles hoy en el mercado presentan tama&#241;os no inferiores a 24-25<span class="elsevierStyleHsp" style=""></span>mm de di&#225;metro&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La poblaci&#243;n del sur de Espa&#241;a presenta un tama&#241;o de la superficie glenoidea inferior a la poblaci&#243;n americana y semejante a la cohorte asi&#225;tica&#46; Los datos antropom&#233;tricos expresados pueden ser &#250;tiles para la elecci&#243;n de la metaglena m&#225;s apropiada en la poblaci&#243;n del sur de Espa&#241;a&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Rosales-Rosales L&#44; Rosales-Varo AP&#44; Garc&#237;a-Espona MA&#44; Roda-Murillo O&#44; Montesinos I&#44; Hernandez-Cort&#233;s P&#46; Estudio antropom&#233;trico de la glena humana en una poblaci&#243;n espa&#241;ola normal&#46; Rev Esp Cir Ortop Traumatol&#46; 2019&#59;63&#58;327&#8211;335&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Max&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ICC &#40;CI 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " rowspan="4" align="left" valign="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">28&#46;65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23&#46;60&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26&#46;90&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">30&#46;30&nbsp;\t\t\t\t\t\t\n
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                  """
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              "imagenFichero" => array:1 [
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        "descripcion" => array:1 [
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Women&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">Weight</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#46;97&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">35&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2117766.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Description of age&#44; height&#44; weight and BMI in women and men and in the total sample&#46;</p>"
        ]
      ]
      8 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Comparison between women and men using Student&#39;s test&#46;</p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Max&#58; maximum value&#59; Min&#58; minimum value&#59; <span class="elsevierStyleItalic">N</span>&#58; sample&#59; p25&#58; percentile 25&#59; p50&#58; median&#59; p75&#58; percentile 75&#59; SD&#58; standard deviation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p50&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Max&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;6&#46;798&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Women&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Men&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">33&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">36&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;68&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">28&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Women&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">30&#46;56&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">30&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">M Leng&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">28&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#8722;6&#46;972&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Women&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">27&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">29&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">30&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">24&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">30&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">32&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">36&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Width 1</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">20&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#8722;8&#46;232&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Women&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;97&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">24&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Width 2</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">154&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">20&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">20&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">22&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Women&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  """
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        "descripcion" => array:1 [
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            "detalle" => "Table "
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