The os acromiale: another cause of impingement

Swain, Randall A.; Wilson, Franklin D.; Harsha, David M.

doi:10.1097/00005768-199612000-00003

Cited by 29 publications

(15 citation statements)

References 10 publications

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“…Os acromiale is often associated with rotator cuff problems and impingement of supraspinatus muscle tendon or other musculature, and a decrease in the subacromial space (Norris et al, 1983;Swain et al, 1996;Davlin & Fluker, 2003). Neer (1983) examined the aetiology of rotator cuff tears and found that the majority of cases were initiated by impingement upon the supraspinatus tendon rather than circulatory problems or trauma.…”

Section: Introductionmentioning

confidence: 99%

The frequency of os acromiale in the Robert J. Terry Collection

Hunt¹,

Bullen²

2006

Intl J of Osteoarchaeology

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Normal fusion of the acromion process in humans begins at about age 15 and should complete ossification by age 22-25. Os acromiale occurs when fusion of the acromial epiphysis does not follow its normal ossification pattern, resulting in the retention of a separate epiphyseal end to the acromial process. Depending on how the metaphyseal junctures fuse, differential size and shape of the unattached acromial segment is produced. As a result of shoulder anatomy and the mobile epiphysis, os acromiale is associated with shoulder impingement and rotator cuff problems. The purpose of this study is to document the frequency of os acromiale in the Robert J. Terry Collection and gain a perspective on the occurrence of os acromiale in this specific US population. The overall frequency of os acromiale in the sample of 1594 skeletons was 8.34%. This study also evaluates the prevalence of os acromiale between sexes and ancestral groups in the Terry Collection. Significant frequency differences in the expression of os acromiale were found between both ancestry and sex; the black male sample has the highest frequency (12.47%), with a lower occurrence in the black female sample (9.22%). The white sample exhibited observably lower frequencies, with the white males at 6.8%, and white females at 3.2%. Size and shape and side expression (laterality) showed no significant differences between the sexes. However, significant differences in laterality by ancestry were observed; black males exhibited 48.3% bilateral expression, while white males exhibited bilateral expression only 29% of the time and 54.8% had a right lateral expression. Based on the results presented in this study, it is suggested that there is a genetic causation for os acromiale, which may or may not be exacerbated by physical activity. The use of this anomaly as an additional non-metric feature in inferring familial relationships and personal identification is discussed.

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Section: Introductionmentioning

confidence: 99%

The frequency of os acromiale in the Robert J. Terry Collection

Hunt¹,

Bullen²

2006

Intl J of Osteoarchaeology

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“…Since it is a rare entity, there are no prospectively controlled studies available and the published studies are, except for that from Neer's group, [20][21][22] of small numbers of patients (Table I). [23][24][25] The wide range of surgical interventions for the condition, from arthroscopic acromioplasty to open osteosynthesis with iliac-crest bone graft, demonstrates the breadth of differing opinions. 9,10,13,14 The purpose of our retrospective The types of os acromiale; A, the space between the os pre-acromiale and the acromion; B, the space between the os meso-acromiale and the acromion (note there is a communication with the acromioclavicular joint, found in all our patients); and C, the space between the os meta-acromiale and the acromion.…”

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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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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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“…Descriptions of the prevalence of os acromiale in symptomatic patients are few. 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] .…”

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 os acromiale: another cause of impingement

Cited by 29 publications

References 10 publications

The frequency of os acromiale in the Robert J. Terry Collection

The frequency of os acromiale in the Robert J. Terry Collection

Os acromiale associated with tear of the rotator cuff treated operatively

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

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