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J Shoulder Elbow Surg. 2016 Mar;25(3):413-21. doi: 10.1016/j.jse.2015.09.016. Epub 2015 Dec 2.

Does scapular morphology affect the integrity of the rotator cuff?

Author information

1
Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India. Electronic address: vivekortho@gmail.com.
2
Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India.
3
Community Medicine and Statistics, Kasturba Medical College, Manipal, Karnataka, India.
4
Department of Radiodiagnosis, Kasturba Medical College, Manipal, Karnataka, India.
5
Shoulder Unit, Lairesse Kliniek, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

Current evidence suggests that distinct scapular morphologies may predispose patients to a rotator cuff tear. The objective of this longitudinal study was to evaluate the relationship between symptomatic degenerative cuff tears and different radiographic acromial characteristics, including acromion shape, indices (acromial index [AI], critical shoulder angle [CSA]), and acromial spur.

METHODS:

We divided 166 patients into 3 groups matched for age and sex: group 1, degenerative full-thickness tear; group 2, partial thickness bursal tear; and group 3, normal cuff. Patients were evaluated with standard radiographs and ultrasonography.

RESULTS:

The presence of an acromial spur was strongly associated with a full-thickness cuff tear (odds ratio, 3.5; P = .001). AI and CSA revealed a statistically significant difference between means of group 1 (P = .006) and group 3 (P < .001). There was no statistically significant difference in means of AI between groups 1 and 2 (P = .695) and between groups 2 and 3, with respect to AI (P = .071) and CSA (P = .125). Receiver operating characteristic curve revealed a higher area for CSA (0.70) than for AI (0.61). Stepwise logistic regression rejected AI as a cuff tear predictor but confirmed CSA and a spur to be stronger predictors of a full-thickness cuff tear. There was no association between the Bigliani acromial type and rotator cuff tear (P = .06).

CONCLUSIONS:

The presence of an acromion spur is strongly associated with full-thickness cuff tear. Higher AI and CSA are associated with a full-thickness tear but not with partial tears. The type of acromion is not related to cuff tear.

KEYWORDS:

Scapular morphology; acromion; acromion index; acromion shape; acromion spur; critical shoulder angle; degenerative tear; rotator cuff

PMID:
26652696
DOI:
10.1016/j.jse.2015.09.016
[Indexed for MEDLINE]

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