Are critical shoulder angle and acromion index correlated to the size of a rotator cuff tear

Tunalı, Onur; Erşen, Ali; Kızılkurt, Taha; Bayram, Serkan; Sıvacıoğlu, Sevan; Atalar, Ata Can

doi:10.1016/j.otsr.2021.103122

Cited by 15 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The AI was another predictor involved in our study, which was proposed even earlier than CSA and was found a value of 0.68 -0.73 was signi cantly associated with a presence of RCTs. 8, [19][20][21] In agreement with the previous studies, the average values of AI in our study were 0.69 in the RCT group and 0.63 in the control group. Theoretically, the larger the lateral extension of acromion is, the higher ascending force the deltoid generates, pulling humeral head upward to impinge against acromion.…”

Section: Comparison Of Predictors Between Groupssupporting

confidence: 92%

The combined utilization of predictors: a better approach to diagnose and predict rotator cuff tears than using a single predictor

Sun

Gao

et al. 2022

Preprint

View full text Add to dashboard Cite

ObjectivesTo explore whether the combined utilization of two predictors is more efficient to predict and diagnose rotator cuff tears (RCTs) than using a single predictor, and to find out which combination is the best screening approach for RCTs.MethodsThis was a retrospective study and patients who visited our hospital and were diagnosed with or without RCTs via magnetic resonance imaging from January 2018 to April 2022 were enrolled and classified into two groups respectively. Four predictors, the critical shoulder angle (CSA), the acromion index (AI), the greater tuberosity angle (GTA) and the double-circle radius ratio (DRR) were picked to participate in the present study. Quantitative variables were compared by independent samples t tests and qualitative variables were compared by chi-square tests to find significant differences between groups. Binary logistic regression analysis was used to distinguish independent risk factors and calculate the increased odds of having a RCT, and construct discriminating combined models to further diagnose and predict RCTs. Receiver operating characteristic (ROC) curves were pictured and areas under the curve (AUC) were calculated to determine the overall diagnostic performance of the involved predictors and the combined models. For all tests a p value of < 0.05 was considered statistically significant.ResultsOne hundred and thirty-nine shoulders with RCTs and 57 shoulders without RCTs were included. The mean values of CSA (35.36 ± 4.57 versus 31.41 ± 4.09°, P = 0.000), AI (0.69 ± 0.08 versus 0.63 ± 0.08, P = 0.000), DRR (1.43 ± 0.10 versus 1.31 ± 0.08, P = 0.000) and GTA (70.15 ± 7.38 versus 64.75 ± 7.91°, P = 0.000) were significantly larger in the RCT group than for controls. Via ROC curves, we found the combined model always showed a better diagnostic performance than either of its contributors, improving the AUC from 0.668–0.823 to 0.751–0.883, and extending the upper boundary of diagnostic sensitivity from 71.9–81.3%, and the diagnostic specificity from 82.5–86.0%. Via logistic regression analysis, we found the values of both predictors over their cutoff values resulted in a dramatical and enormous increasement (20.169–161.214 folds) in the risk of having a RCT, which is far beyond that by using a single predictor only (2.815–11.191 folds).ConclusionThe combined utilization of predictors is a better approach to diagnose and predict RCTs than using a single predictor. With a comprehensive consideration on the diagnostic and predictive performance of the combined models, we conclude the CSA together with the DRR present the strongest detectability for a presence of RCTs.

show abstract

Section: Comparison Of Predictors Between Groupssupporting

confidence: 92%

The combined utilization of predictors: a better approach to diagnose and predict rotator cuff tears than using a single predictor

Sun

Gao

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In our study, the mean values of CSA were 35.36° in the RCT group and 31.41° in the control group, which was compatible with those revealed in previous researches. The AI was another predictor involved in our study, which was proposed even earlier than CSA and was found a value of > 0.68—0.73 was significantly associated with a presence of RCTs [ 3 , 14 – 16 ]. In agreement with the previous studies, the average values of AI in our study were 0.69 in the RCT group and 0.63 in the control group.…”

Section: Discussionmentioning

confidence: 99%

The combined utilization of predictors seems more suitable to diagnose and predict rotator cuff tears

Sun

Guo

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Morphological markers presenting the lateral extension of acromion and the greater tuberosity of humerus were proposed to diagnose and predict rotator cuff tears (RCTs) in recent years, but few studies have addressed the combined performance when using two predictors together. As a presence of a RCT may be associated with the impingement caused by both acromion and the greater tuberosity, we believe a combined utilization of predictors could result in a better diagnostic and predictive performance than using a single predictor. The aim of this study is to (i) explore whether the combination is more efficient to predict and diagnose RCTs; (ii) find out which combination is the most superior screening approach for RCTs. Methods This was a retrospective study and patients who visited our hospital and were diagnosed with or without partial-thickness or full-thickness RCTs via magnetic resonance imaging from January 2018 to April 2022 were enrolled and classified into two groups respectively. Four predictors, the critical shoulder angle (CSA), the acromion index (AI), the greater tuberosity angle (GTA) and the double-circle radius ratio (DRR) were picked to participate in the present study. Quantitative variables were compared by independent samples t tests and qualitative variables were compared by chi-square tests. Binary logistic regression analysis was used to construct discriminating combined models to further diagnose and predict RCTs. Receiver operating characteristic (ROC) curves were pictured to determine the overall diagnostic performance of the involved predictors and the combined models. Results One hundred and thirty-nine shoulders with RCTs and 57 shoulders without RCTs were included. The mean values of CSA (35.36 ± 4.57 versus 31.41 ± 4.09°, P < 0.001), AI (0.69 ± 0.08 versus 0.63 ± 0.08, P < 0.001), DRR (1.43 ± 0.10 versus 1.31 ± 0.08, P < 0.001) and GTA (70.15 ± 7.38 versus 64.75 ± 7.91°, P < 0.001) were significantly higher in the RCT group than for controls. Via ROC curves, we found the combined model always showed a better diagnostic performance than either of its contributors. Via logistic regression analysis, we found the values of both predictors over their cutoff values resulted in an increasement (20.169—161.214 folds) in the risk of having a RCT, which is more than that by using a single predictor only (2.815 -11.191 folds). Conclusion The combined utilization of predictors is a better approach to diagnose and predict RCTs than using a single predictor, and CSA together with DRR present the strongest detectability for a presence of RCTs.

show abstract

“…Numerous studies have documented that CSA values >33–35° are correlated with rotator cuff tears (RCTs) and a higher retear rate after arthroscopic rotator cuff repair (RCR). CSAs <30° are associated with glenohumeral osteoarthritis (GHOA) 5–12 . Hence, accurate measurement of CSA and reduction of excessive CSA to a desirable range by acromioplasty is expected to offer marked clinical benefit.…”

Section: Introductionmentioning

confidence: 99%

The Critical Shoulder Angle Can be Accurately and Reliably Determined from Three‐Dimensional Computed Tomography Images

Long

Zhou

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveAnteroposterior (AP) radiographs do not necessarily offer the optimal approach to measuring the critical shoulder angle (CSA) due to the malposition of the scapula. Three‐dimensional computed tomography (3D‐CT) may offer some advantages, including the ability to rotate the scapula for position alignment and pre‐operative planning for reducing CSA. This study aimed to investigate the accuracy and reliability of CSA measurement in 3D‐CT and to determine whether there is an association between CSA and rotator cuff tears (RCTs).MethodsIn this retrospective study we identified 200 patients who received shoulder arthroscopy from 2019 to 2021, including 142 patients (81 females, 61 males) with RCTs and 58 patients (14 females, 44 males) with non‐RCTs. For each participant, CSA was measured from standard shoulder AP radiographs and anterior views of 3D‐CT of the scapula by two independent assessors. Inter‐ and intra‐observer agreements were assessed by the intraclass correlation coefficient (ICC). The relationship between the two measurement methodologies was determined by Spearman's correlation coefficient and Bland–Altman plots. Discriminative capacity was calculated by using receiver operating curve (ROC) analyses in the whole cohort and age sub‐groups above and below 45 years.ResultsWe found perfect inter‐observer (ICC >0.96) and intra‐observer (ICC >0.97) reliabilities for CSA measurements obtained from the standard AP radiographs and the 3D‐CT. There was a strong correlation between the two methods (r = 0.960, P < 0.001). The mean CSA was 31.7° ± 4.2° in the standard AP radiographs and 31.8° ± 4.4° in the 3D‐CT (mean difference 0.02°, P = 0.940; bias 0.02°, limits of agreement −2.29° to +2.33°). ROC analysis of the whole cohort showed that the CSA measured in the standard AP radiographs (area under the ROC curve [AUC] = 0.812, P < 0.001) and the 3D‐CT (AUC = 0.815, P < 0.001) predicted RCT with high confidence. ROC analysis of patients aged ≥45 years showed that the CSA measured from the standard AP radiographs (AUC = 0.869, P < 0.001) and the 3D‐CT (AUC = 0.870, P < 0.001) were very good at predicting RCTs.ConclusionCSA measured from standard AP radiographs and 3D‐CT showed high consistency, and the CSA could be accurately and reliably measured using 3D‐CT. CSAs measured from standard AP radiographs and 3D‐CT could predict RCTs, especially in patients aged ≥45 years.

show abstract

Are critical shoulder angle and acromion index correlated to the size of a rotator cuff tear

Cited by 15 publications

References 24 publications

The combined utilization of predictors: a better approach to diagnose and predict rotator cuff tears than using a single predictor

The combined utilization of predictors: a better approach to diagnose and predict rotator cuff tears than using a single predictor

The combined utilization of predictors seems more suitable to diagnose and predict rotator cuff tears

The Critical Shoulder Angle Can be Accurately and Reliably Determined from Three‐Dimensional Computed Tomography Images

Contact Info

Product

Resources

About