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The Critical Shoulder Angle: Acromial Coverage is More Relevant than Glenoid Inclination


Beeler, Silvan; Hasler, Anita; Götschi, Tobias; Meyer, Dominik C; Gerber, Christian (2019). The Critical Shoulder Angle: Acromial Coverage is More Relevant than Glenoid Inclination. Journal of Orthopaedic Research, 37(1):205-210.

Abstract

It is still unknown whether glenoid inclination or lateral acromial roof extension is a more important determinant for development of rotator cuff tears (RCT) or osteoarthritis (OA) of the shoulder. It was the purpose of this study, to evaluate whether there is a potential predominance of one of these factors in pathogenesis of RCT or concentric OA. We analyzed 70 shoulders with advanced degenerative RCT and 54 shoulders with concentric OA undergoing primary shoulder arthroplasty (anatomical or reverse) using antero-posterior radiography and multiplanar computed tomography. The two groups were compared in relation to glenoid inclination, lateral acromion roof extension, acromial height and critical shoulder angle (CSA). All measured parameters were highly significantly different between RCT and concentric OA (p < 0.001). Based on Cohen's d effect size, group differences were most distinct in lateral acromial roof extension (1.36 , 0.92 ) compared with acromial height (1.06 , 0.73 ) and glenoid inclination (0.60 , 0.61 ). However, no single factor showed an effect size which was as high as that of the CSA (1.63 ). Interestingly, a ratio of lateral acromion roof extension and acromial height could enhance the effect size (1.60 , 1.16 ) near to values of the CSA (1.63 ). In summary, lateral acromial roof extension has a greater influence in pathogenesis of degenerative RCT and concentric OA than acromial height or glenoid inclination. This article is protected by copyright. All rights reserved.

Abstract

It is still unknown whether glenoid inclination or lateral acromial roof extension is a more important determinant for development of rotator cuff tears (RCT) or osteoarthritis (OA) of the shoulder. It was the purpose of this study, to evaluate whether there is a potential predominance of one of these factors in pathogenesis of RCT or concentric OA. We analyzed 70 shoulders with advanced degenerative RCT and 54 shoulders with concentric OA undergoing primary shoulder arthroplasty (anatomical or reverse) using antero-posterior radiography and multiplanar computed tomography. The two groups were compared in relation to glenoid inclination, lateral acromion roof extension, acromial height and critical shoulder angle (CSA). All measured parameters were highly significantly different between RCT and concentric OA (p < 0.001). Based on Cohen's d effect size, group differences were most distinct in lateral acromial roof extension (1.36 , 0.92 ) compared with acromial height (1.06 , 0.73 ) and glenoid inclination (0.60 , 0.61 ). However, no single factor showed an effect size which was as high as that of the CSA (1.63 ). Interestingly, a ratio of lateral acromion roof extension and acromial height could enhance the effect size (1.60 , 1.16 ) near to values of the CSA (1.63 ). In summary, lateral acromial roof extension has a greater influence in pathogenesis of degenerative RCT and concentric OA than acromial height or glenoid inclination. This article is protected by copyright. All rights reserved.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 January 2019
Deposited On:18 Sep 2018 12:59
Last Modified:24 Sep 2019 23:36
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0736-0266
OA Status:Green
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1002/jor.24053
PubMed ID:29774949

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