Correlation of acromial morphology with impingement syndrome and rotator cuff tears

Abstract

Background and purpose Indications for acromioplasty are based on clinical symptoms and are generally supported by typical changes in acromial morphology on standard radiographs. We evaluated 5 commonly used radiographic parameters of acromial morphology and assessed the association between different radiographic characteristics on the one hand and subacromial impingement or rotator cuff tears on the other.Patients and methods We measured acromial type (Bigliani), acromial slope (AS), acromial tilt (AT), lateral acromial angle (LAA), and acromion index (AI) on standard radiographs from 50 patients with full-thickness supraspinatus tendon tears, 50 patients with subacromial impingement, and 50 controls without subacromial pathology.Results The acromial type according to Bigliani was not associated with any particular cuff lesion. A statistically significant difference between controls and impingement patients was found for AS. AT of controls was significantly smaller than that of impingement patients and cuff-tear patients. LAA of cuff-tear patients differed significantly from that of controls and impingement patients, but LAA of controls was not significantly different from that of impingement patients. Differences between impingement patients and cuff-tear patients were also significant. AI of controls was significantly lower than of impingement patients and of cuff-tear patients. A good correlation was found between acromial type and AS.Interpretation A low lateral acromial angle and a large lateral extension of the acromion were associated with a higher prevalence of impingement and rotator cuff tears. An extremely hooked anterior acromion with a slope of more than 43° and an LAA of less than 70° only occurred in patients with rotator cuff tears.

May Ursodeoxycholic Acid Significantly Improve Liver Function Tests among Patients with Hepatitis C?

“…In a recent study, Balke at al investigates acromial morphology and impingement syndrome and they emphasize that the acromial type according to Bigliani was not associated with any particular cuff lesion [20]. In our study we also find no correlation between acromion types and tear type, and only19.5% of patients have type III acromion.…”

The acromiohumeral centre edge angle: A new radiographic measurement and its association with rotator cuff pathology

“…Despite this, the average AI in our rotator cuff tear group (0.755) was comparable with that reported in other studies 3,4,6,11-13 Similarly, the average LAA in our rotator cuff tear group (76.48 ) was similar to that reported by Balke (77 ). 3 The average ACEA in our rotator cuff tear group of patients was significantly higher than our control group indicating a greater amount of humeral head coverage. A greater amount of humeral head coverage could plausibly result in higher rates of rotator cuff impingement and tears due to a compression effect as has been previously described in the literature.…”

“…15 Balke et al found that patients with rotator cuff tears had significantly lower LAAs and higher AIs than a control group without shoulder pathology. 3 In contrast, Baechler and Kim found that the percentage of humeral head not covered superiorly and laterally by the acromion may be a factor in the pathogenesis of rotator cuff tears due to hinging of the humeral head on the anterolateral edge of the acromion during early shoulder abduction causing impingement of supraspinatus between these two structures. 16 Similarly, Melean et al found no positive correlation between a larger AI and the incidence of recurrent rotator cuff tears.…”

“…a downsloping acromion) has been reported as being associated with higher rates of rotator cuff tear. 3 Nyffeler et al introduced the acromial index (AI) which describes the lateral extension of the acromion. 4 Measured on true anteroposterior radiographs, it is a ratio of glenoacromial (GA) to glenohumeral (GH) distance where a higher AI (i.e.…”

Rotator manşet rüptürünün nadir bir nedeni: Subakromial osteokondrom

“…Rotator manşet rüptürü, genellikle orta ve ileri yaşta görülen, ana semptomları ağrı ve eklem hareket açıklığında azalma olan, sık görülen bir dejeneratif tendon yaralanması olup nadiren travmaya bağlıdır (1). Genellikle anterolateral akromion ventral yüzü, korakoakromial ligaman ya da distal klavikulanın ventral yüzünün neden olduğu mekanik irritasyon sonucu oluşur (2).…”