Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears

Balke, Maurice; Liem, Dennis; Greshake, Oliver; Hoeher, Juergen; Bouillon, Bertil; Banerjee, Marc

doi:10.1007/s00167-014-3499-y

Cited by 102 publications

(90 citation statements)

References 39 publications

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“…In the present study, the morphological acromial differences between impingement and control patients indicate that the impinged acromia are more prominent anteriorly and inferiorly. These results were consistent with previous reports [12,16,17,24]. Nevertheless, these data could only support the correlation, but not the causal relationship, of acromial morphology and subacromial impingement.…”

Section: Discussionsupporting

confidence: 92%

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Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis

et al. 2017

PLoS ONE

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Purpose: To evaluate the association of acromial morphology and subacromial impingement. Methods: Bilateral shoulder computed tomography was performed in 138 patients who received shoulder arthroscopy. Measured parameters included: acromial tilt (AT), modified acromial tilt (mAT), acromial slope (AS), acromiohumeral interval (AHI), lateral acromial angle (LAA), acromial index (AI), critical shoulder angle (CSA), acromial anterior protrusion (AAP), and acromial inferior protrusion (AIP). Acromial morphological characteristics were compared between groups. Side-to-side differences were assessed between affected and non-affected shoulders. Intra- and inter-observer agreements for each parameter were calculated. Results: AT (25.90 vs. 29.41°), mAT (18.88 vs. 22.64°), and AHI (5.46 vs. 6.47 mm) were significantly smaller in impinged patients. The impingement group demonstrated significantly larger AI (63.50 vs. 59.84%), CSA (31.78 vs. 28.74°), AAP (7.13 vs. 5.32 mm), and AIP (5.51 vs. 4.04 mm). Regarding side-to-side comparison, the acromial morphology was significantly different between the affected and non-affected shoulders in impinged patients, while the difference was slight and insignificant in control patients. All, except AS and LAA, measured parameters demonstrated good intra- and inter-observer agreements. Conclusions: Three-dimensional reconstructed CT scan is a reliable method to measure shoulder morphology. The acromial morphological variation is related with sub acromial impingement, however, the causal relationship of them should be further explored.

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Section: Discussionsupporting

confidence: 92%

“…Among them, AT and AS were index of acromial inferior protrusion, AHI indicated the superior migration of humeral head, and LAA, AI, and CSA represented the lateral prominence of acromion [12,16,17,24]. However, the agreement for those parameters measured on X-rays was poor [11].…”

Section: Discussionmentioning

confidence: 99%

Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis

et al. 2017

PLoS ONE

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“…In particular, Miyazaki et al6) reported contrasting results obtained from two different races: the AI was a possible cause of rotator cuff tears only in a Brazilian population, not in a Japanese population. However, Moor et al10) and Balke et al14) recently described that distinct scapular morphologies including the AI accurately predicted the degenerative rotator cuff tear as radiologic parameters. Ames et al15) reported there was an association between the AI and the outcomes of arthroscopic rotator cuff repairs in 120 shoulders.…”

Section: Discussionmentioning

confidence: 99%

Acromion Index in Korean Population and Its Relationship with Rotator Cuff Tears

et al. 2017

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BackgroundAmong the many causes of rotator cuff tears, scapular morphology is associated with the accelerating degenerative process of the rotator cuff. Acromion index (AI) was previously introduced and compared in two populations.MethodsWe enrolled 100 Korean patients diagnosed with full-thickness rotator cuff tears by magnetic resonance imaging and intraoperative arthroscopic findings between January and December 2013. Another 100 Korean patients with an intact rotator cuff tendon identified on magnetic resonance imaging and other shoulder diseases, such as frozen shoulder and instability, were enrolled as controls. We retrospectively compared these 100 rotator cuff tear patients (mean age, 63 years) and 100 controls (mean age, 51 years) in this study. Two independent orthopedic surgeons assessed the AI on radiographs. We performed an interobserver reliability test of the AI assessment, and then compared the AI between two groups.ResultsThe measurement of the AI showed excellent reliability (intraclass correlation coefficient, 0.82). The mean AI in the rotator cuff tear group was 0.68 and it was significantly different between groups (p<0.001, 95% confidence interval). The AI was not related to tear size.ConclusionsOur study showed that the AI was an effective predictive factor for rotator cuff tears in a Korean population.

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“…Zumstein et al 20 identified a wide lateral extension of the acromion as a risk factor for re-tearing after open repair of massive tears. Balke et al 21 showed that shoulders with degenerative tears had a significantly larger lateral extension of the acromion than shoulders with traumatic supraspinatus tendon tears. Hamid et al 22 found excellent inter-observer reliability of the AI but no difference between patients with rotator cuff tears and individuals with no history of rotator cuff pathology.…”

Section: Acromion Shape In the Coronal Planementioning

confidence: 99%

Acromion and glenoid shape: Why are they important predictive factors for the future of our shoulders?

Nyffeler

Meyer

2017

EFORT Open Reviews

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The shape of the acromion differs between patients with degenerative rotator cuff tears and individuals without rotator cuff pathology.It can be assessed in the sagittal plane (acromion type, acromion slope) and in the coronal plane (lateral acromion angle, acromion index, critical shoulder angle).The inter-observer reliability is better for the measurements in the coronal plane.A large lateral extension (high acromion index or high critical shoulder angle) and a lateral down-sloping of the acromion (low lateral acromion angle) are associated with full-thickness supraspinatus tears.The significance of glenoid inclination for rotator cuff disease is less clear.The postulated patho-mechanism is the compression of the supraspinatus tendon between the humeral head and the acromion. Bursal side tears might be caused by friction and abrasion of the tendon. Articular side tears could be due to impairment of the gliding mechanism between tendon fibrils leading to local stress concentration. Further research is needed to understand the exact pathomechanism of tendon degeneration and tear.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160076. Originally published online at www.efortopenreviews.org

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Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears

Abstract: IV.

Cited by 102 publications

References 39 publications

Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis

Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis

Acromion Index in Korean Population and Its Relationship with Rotator Cuff Tears

Acromion and glenoid shape: Why are they important predictive factors for the future of our shoulders?

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