A Comparative Morphological Analysis of the Glenohumeral Joint in Male and Female Adult Shoulders

Background: Shoulder joint morphology affects stability and prosthesis design, but Pakistani data are scarce. Objectives: To Quantify glenoid and humeral head dimensions in male vs. female Pakistani cadavers and relate them to bone biomarkers. Methods: Fifty unpaired shoulders (25 male, 25 female; age 30–70 years) were dissected at Pakistani medical colleges (Sep 2023–Sep 2024). Exclusions: prior surgery, osteoarthritis, trauma, congenital anomalies. Digital calipers measured glenoid width, glenoid height, humeral head diameter, and head height. Postmortem serum 25(OH)D, calcium, phosphate, PTH, and ALP were assayed. Independent t-tests compared sexes; Pearson correlation evaluated biomarker–dimension associations. Results: Males had larger glenoid width (27.5 ± 2.3 vs. 24.1 ± 2.0 mm), height (34.2 ± 2.8 vs. 30.7 ± 2.5 mm), head diameter (48.3 ± 3.5 vs. 43.7 ± 3.1 mm), and height (41.0 ± 3.2 vs. 37.2 ± 2.9 mm) (p < 0.001). Females showed lower 25(OH)D (18.4 ± 6.8 vs. 23.5 ± 7.2 ng/mL; p = 0.02), higher PTH (55 ± 15 vs. 45 ± 12 pg/mL; p = 0.04), and ALP (22 ± 6 vs. 18 ± 5 IU/L; p = 0.03). Vitamin D correlated with glenoid width (r = 0.34; p = 0.01) and head diameter (r = 0.31; p = 0.02); PTH inversely correlated with head height (r = −0.34; p = 0.01). Conclusion: Pronounced sexual dimorphism exists in Pakistani glenohumeral morphology. Sex-specific prosthesis sizing and preoperative metabolic assessment may improve surgical outcomes.