Os acromiale associated with tear of the rotator cuff treated operatively

Boehm, Thomas Dirk; Matzer, M.; Brazda, D.; Gohlke, Frank

doi:10.1302/0301-620x.85b4.13634

Cited by 51 publications

(72 citation statements)

References 26 publications

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“…As the incidence of os acromiale in the most recent skeleton studies was 8% (Edelson et al 1993, Nicholson et al 1996, Sammarco 2000, it seems unlikely that os acromiale has a pathological effect on rotator cuff diseases. This should be considered in preoperative decision making in rotator cuff surgery, especially as the fusion of os acromiale after rotator cuff repair has not shown superior clinical results as compared to acromioplasty and unsuccessful fusion (Boehm et al 2003).…”

Section: Discussionmentioning

confidence: 99%

“…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).…”

mentioning

confidence: 99%

“…It is usually associated with subacromial impingement (Hutchinson andVeenstra 1993, Jerosch et al 1994) or rotator cuff tears (Mudge et al 1984, Park et al 1994, Boehm et al 2003. Mudge et al (1984) have been the only authors to report the incidence of os acromiale in patients with rotator cuff tears, and found 9 os acromiale in 145 patients (6%).…”

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confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Rotator cuff tears associated with os acromiale

Boehm¹,

Rolf²,

Martetschlaeger³

et al. 2005

Acta Orthopaedica

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“…They may, however cause symptoms as a result of dynamic impingement with deltoid contraction [7] . Os acromiales have also been associated with rotator cuff pathology, including rotator cuff tears [3,5,[8][9][10][11] . Descriptions of the prevalence of os acromiale in symptomatic patients are few.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, since it is a rare entity, there are no prospectively controlled studies available and the published studies are generally of small numbers of patients [12][13][14] . As most studies examining the prevalence of os acromiale do not comment on the prevalence of rotator cuff tears, the rate of rotator cuff disease in the presence of os acromiale remains largely unknown [2,3,6,8] . There are a number of reports which suggest that os acromiale may not be associated with an increased prevalence of rotator cuff tears [4,5,15] .…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of os Acromiale in Patients with Massive Rotator Cuff Tears

Atoun

Narvani

Sforza

et al. 2016

International Journal of Orthopaedics

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repair of the rotator cuff tear when managing patients with both os acromiale and massive rotator cuff tears. INTRODUCTIONOs acromiale, a condition characterised by fusion failure of the acromion ossification centers, has a reported prevalence of ranging from 1% to 15% [1,2] . There are four separate ossification centers including basi-acromion, meta-acromion, mesa-acromion and the pre-acromion. Fusion of pre-acromion, mesa-acromion and metaacromion usually occurs between the ages of 15 and 18 whereas scapular spine is reported to fuse with basi-acromion earlier (by age of 12) [1] . Traditionally os acromiale has been classified into 3 types. Pre-acromion os acromiale is failure of union between pre-acromion and mesa-acromion, whereas meso-acromion os acromiale, which is the commonest type, is failure of fusion between mesa and meta-acromion. Similarly failure of union between meta-and basiacromions is termed meta-acromion os acromiale.Most patients, however, are asymptomatic and diagnosis is made incidentally while investigating the shoulder for unrelated pathology. In a minority symptoms may arise as result of motion of the unfused fragment leading to pain at the acromioclavicular joint or os site [3] . Patient may also present with impingement type symptoms due to the inferior tilting of unstable os fragment with deltoid contraction. Narrowing of the supraspinatus outlet, and secondary impingement, may also result from spur formation at the interference between the two unfused os fragments [3] . ABSTRACT AIM: Os acromiale is a rare shoulder condition, which may be symptomatic. The rate of rotator cuff disease in the presence of os acromiale is unknown. The aim of this study was to investigate the prevalence of os acromiale in patients with massive rotator cuff tears and in those with cuff tear arthropathy. MATERIAL AND METHODS: Prospective data collection was performed on all patients who were treated for massive rotator cuff tear and\or cuff arthropathy in our unit in period of one year. In particular presence or absence of os acromiale, size of rotator cuff tear and signs of arthritic changes were noted. These were detected by various ways including plain radiograph, computed tomography, magnetic resonance imaging or arthroscopy. RESULTS: We found that 16 out of 135 (12%) of patients with massive rotator cuff tears had an associated os acromiale. Furthermore, 26 out of 82 (32%) patients with cuff arthropathy had an associated os acromiale. CONCLUSION: Our study provides evidence that os acromiale is associated with massive rotator cuff tears and cuff arthropathy. It may suggest that os acromiale plays a role in pathophysiology of massive tears and that it may need to be addressed in addition to

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The prevalence of os acromiale: A systematic review and meta‐analysis

Yammine

2013

Clinical Anatomy

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Os acromiale (OA) results from a failure of consolidation between the ossification centers of the acromial epiphysis. Its prevalence and its interactions with ancestry, gender, laterality, and side have been variously reported in the literature. The aims of this review are to provide an accurate estimate of OA prevalence and to investigate its association with other variables in an attempt to comprehend its etiology. Twenty-three studies met the inclusion criteria. The results of meta-analyses of large-sample studies revealed: (a) a crude overall prevalence of 7.0%, (b) a crude cadaveric prevalence of 7.6%, (c) a crude archeological (skeletal) prevalence of 5.6%, (d) a crude radiological prevalence of 4.2%, (e) a true anatomical prevalence of 9.6%, (f) a significantly higher frequency in persons of black ancestry than in persons of white, Native American and Middle Eastern ancestries (OR ≈ 3), (g) significantly higher unilateral and bilateral frequencies in black ancestry (OR of 2 and 4, respectively), (h) nonsignificant interactions of OA frequency with gender and side. The commonest type of OA was the meso-acromion type (76.6%). Degenerative changes were present in 66.6% of OAs. The results of this evidence-based anatomical review support a genetic basis for OA rather than the mechanical trauma-induction hypothesis.

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Os acromiale associated with tear of the rotator cuff treated operatively

Cited by 51 publications

References 26 publications

Rotator cuff tears associated with os acromiale

Rotator cuff tears associated with os acromiale

The Prevalence of os Acromiale in Patients with Massive Rotator Cuff Tears

The prevalence of os acromiale: A systematic review and meta‐analysis

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