Acromion-splitting approach through an os acromiale for repair of a massive rotator cuff tear

Richman, Neil; Curtis, Alan S.; Hayman, Michael J.

doi:10.1016/s0749-8063(97)90197-3

Cited by 11 publications

(7 citation statements)

References 8 publications

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“…In large posteriorly located tears of the rotator cuff with an unstable os acromiale, a transacromial approach as described by Richmann et al 11 and Hertel et al,7 may be used to avoid compromising the anterior blood supply of the os acromiale and to allow better visualisation of the posterior rotator cuff. Our total Constant scores were within the range reported by others.…”

Section: Discussionmentioning

confidence: 99%

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Os acromiale associated with tear of the rotator cuff treated operatively

Boehm

Matzer

Brazda

et al. 2003

The Journal of Bone and Joint Surgery. British volume

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Os acromiale is a rare anatomical abnormality and treatment is controversial. Our retrospective study analyses the outcome of excision, acromioplasty and bony fusion of the os acromiale when it is associated with a tear of the rotator cuff. After a mean follow-up of 41 months, 33 patients were radiologically and clinically assessed using the Constant score. The surgical procedure was to repair the rotator cuff together with excision of the os acromiale in six patients, acromioplasty in five, and fusion in 22. Of the 22 attempted fusions seven failed radiologically. The Constant scores were 82%, 81%, 81% and 84% for patients who had excision, acromioplasty, successful fusion and unsuccessful fusion respectively. There were no statistically significant differences. We conclude that a small mobile os acromiale can be resected, a large stable os acromiale treated by acromioplasty and a large unstable os acromiale by fusion to the acromion. Even without radiological fusion the clinical outcome can be good.

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Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13] Warner, Beim and Higgins 14 reported three surgically treated patients with os acromiale located between the meta-acromion and the basi-acromion.…”

mentioning

confidence: 99%

Os acromiale associated with tear of the rotator cuff treated operatively

Boehm

Matzer

Brazda

et al. 2003

The Journal of Bone and Joint Surgery. British volume

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“…There are 3 types of os acromiale: the preacromion, the meso-acromion (commonest) and the meta-acromion (Macalister 1893) (Figure 1). The literature mainly describes os meso-acromiale and os pre-acromiale (Burkhart 1992, Hutchinson and Veenstra 1993, Jerosch et al 1994, Richman et al 1997, Hertel et al 1998, Warner et al 1998, Satterlee 1999, Wright et al 2000, Boehm et al 2003) Warner et al (1998) reported the treatment of 3 symptomatic os meta-acromiale. The reported incidence of os acromiale ranges from 1% to 15% (Table1).…”

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confidence: 99%

Rotator cuff tears associated with os acromiale

Boehm¹,

Rolf²,

Martetschlaeger³

et al. 2005

Acta Orthopaedica

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Introduction Os acromiale is a rare anatomical condition; its incidence in cadaver studies has been found to be approximately 8%. In this retrospective study we investigated the incidence and types of os acromiale in patients with rotator cuff tears.Methods We assessed operation notes and axillary radiographs for the presence and the type of os acromiale in 1 000 consecutive patients with open rotator cuff repairs.Results 62 patients (6.2%) showed an os acromiale in the axillary radiographs. In 6 of these the os acromiale was not described in the operation notes. 57 os meso-acromiale and 5 os pre-acromiale were found. The average number of tendons involved in the cuff tear was the same (1.4) in patients with and without os acromiale. The average age of patients with os acromiale was 55 years, and 56 years in patients without os acromiale.Interpretation Os acromiale is a co-condition in patients with rotator cuff tear. The prevalence of os acromiale in patients with rotator cuff tear is similar to that in a standard population with unknown integrity status of the rotator cuff. Thus, it seems debatable whether an os acromiale is a pathological condition leading to rotator cuff tears.

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“…However, for the treatment of asymptomatic os acromiale, an acromion-splitting approach with deltoid splitting to achieve visualization of the rotator cuff has been reported. 2 , 5 , 10 Richman et al 10 described a procedure in which the deltoid was split along its fibers to achieve good visualization of the rotator cuff. After good bony coverage had been achieved with the rotator cuff repair, the os acromiale fragment was fixated to the remainder of the acromion with a 4-0 cannulated screw.…”

Section: Discussionmentioning

confidence: 99%