Anterolateral Acromioplasty Does Not Change the Critical Shoulder Angle and Acromion Index in a Clinically Relevant Amount

Thiesemann, Sophie; Kirchner, Florian; Fal, Milad Farkhondeh; Albers, Sebastian; Kircher, Jörn

doi:10.1016/j.arthro.2022.06.018

Cited by 5 publications

(2 citation statements)

References 55 publications

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“…Lin et al 50 showed that anterolateral acromioplasty effectively reduced CSA and this is more significant among individuals with CSA ≥38 degrees than among those with CSA <38 degrees. Conversely, Thiesemann et al 51 concluded that anterolateral acromioplasty did not result in a significant change in the CSA; a significant reduction was observed in the case of CSA >35 degrees but not to normal values. Zhang and colleagues observed that acromioplasty could significantly reduce CSA, especially in cases of high preoperative CSA.…”

Section: Discussionmentioning

confidence: 94%

Critical Shoulder Angle in Patients With Cuff Tears

Cerciello,

Mocini,

Proietti

et al. 2024

Sports Medicine and Arthroscopy Review

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Objective: The pathogenesis of rotator cuff tears (RCTs) is multifactorial. Critical shoulder angle (CSA), which represents the lateral extension of the acromion over the cuff, has been proposed as an extrinsic risk factor. The aim of the present systematic review and meta-analysis was to analyze the available literature regarding the correlation between RCT and CSA. Methods: A review was carried out in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” guidelines on July 17, 2023, using the following databases: PubMed, Ovid, and Cochrane Reviews. The following keywords were used: “critical shoulder angle,” “rotator cuff tears,” and “rotator cuff lesions.” The methodological quality of the studies was assessed with the MINORS SCORE. Results: Twenty-eight studies were included. The average CSA among the 2110 patients with full-thickness RCT was 36.7 degrees, whereas the same value among the 2972 controls was 33.1 degrees. The average CSA in the 348 patients with partial-thickness RCT was 34.6 degrees, whereas it was 38.1 degrees in the 132 patients with massive RCT. The average MINORS score was 15.6. Conclusions: CSA values were significantly higher in patients with RCT compared with the asymptomatic population. In addition, it appears that CSA values increase with the severity of rotator cuff involvement.

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Section: Discussionmentioning

confidence: 94%

Critical Shoulder Angle in Patients With Cuff Tears

Cerciello,

Mocini,

Proietti

et al. 2024

Sports Medicine and Arthroscopy Review

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“…51 Thiesemann et al unveiled noteworthy alterations in the LAA subsequent to anterolateral acromioplasty and postoperative procedures. 52 Morphological analysis of the acromion in patients with degenerative supraspinatus tendon tears has highlighted resemblances to those with traumatic tears. This is characterized by a narrower subacromial gap, heightened lateral extension, and an inclination of the acromion angle.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Lateral Acromion Angle in Rotator Cuff Tear Patients with Acromioplasty

Hong,

Kong,

Zhang

et al. 2023

Orthopaedic Surgery

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BackgroundArthroscopic surgery has been established as an efficacious intervention for the treatment of rotator cuff tears. The primary aim of this study was to analyze the modifications in the lateral acromial angle (LAA) subsequent to rotator cuff repair surgery using single‐row rivet fixation and double‐row rivet fixation techniques. Furthermore, we sought to investigate the influence of LAA on the prognosis of rotator cuff repair surgery.MethodThis observational study retrospectively enrolled 105 patients diagnosed with degenerative rotator cuff tears who underwent arthroscopic rotator cuff repair between 2016 and 2019. Following the exclusion of two patients with subscapularis or superior labrum anterior and posterior (SLAP) tears, as well as three patients who were lost to follow‐up, a cohort of 100 patients was included for clinical and imaging evaluation. Among these individuals, 50 were assigned to the double‐row repair group, whereas the remaining 50 comprised the single‐row repair group. Bilateral shoulder magnetic resonance imaging (MRI) scans were conducted no less than 24 months post‐surgery. Experienced arthroscopic surgeons, blinded to the LAA measurements, assessed the rotator interval (RI) using a control MRI. Functional assessment was performed using the University of California, Los Angeles (UCLA) quick disability of the shoulder and arm, shoulder and hand (qDASH) score. The Wilcoxon signed‐rank test for dependent samples was employed to compare data between the pre‐ and post‐intervention groups. Pearson correlation coefficients were calculated to evaluate the relationship between different parameters.ResultsThe study population consisted of 73 female patients and 27 male patients, with a mean age of 58.32 ± 5.29 years and a mean follow‐up duration of 25.88 ± 8.11 months. Preoperatively, the mean LAA was 75.81° ± 11.28°, RI was 4.78 ± 0.62, UCLA score was 17.54 ± 2.44, and qDASH score was 2.45 ± 0.25. The average tear size was 8.95 ± 2.11 mm. A statistically significant difference in LAA was observed between the preoperative and postoperative measurements, with the double‐row repair group exhibiting a greater LAA than the single‐row repair group. Finally, a significant correlation was identified between LAA, RI, and qDASH scores after a 24‐month follow‐up period.ConclusionAccording to our findings, the utilization of double‐row rivet fixation has a greater LAA angle than single‐row rivet fixation. Moreover, this preservation of LAA is significantly associated with the functional recovery of the shoulder joint.

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Editorial Commentary: Classic Arthroscopic Anterolateral Acromioplasty Does Not Translate to Clinically Meaningful Differences in Lateral Acromial Overcoverage

Waterman¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Anterolateral Acromioplasty Does Not Change the Critical Shoulder Angle and Acromion Index in a Clinically Relevant Amount

Cited by 5 publications

References 55 publications

Critical Shoulder Angle in Patients With Cuff Tears

Critical Shoulder Angle in Patients With Cuff Tears

Changes in the Lateral Acromion Angle in Rotator Cuff Tear Patients with Acromioplasty

Editorial Commentary: Classic Arthroscopic Anterolateral Acromioplasty Does Not Translate to Clinically Meaningful Differences in Lateral Acromial Overcoverage

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