Nazım KARAHAN
(Çorlu Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Tekirdağ, Türkiye)
Barış YILMAZ
(Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul, Türkiye)
Ahmet ÖZTERMELİ
(Gebze Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Gebze, Türkiye)
Murat KAYA
(Marmara Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul, Türkiye)
Serda DUMAN
(Selahattin Eyyubi Devlet Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, Diyarbakır, Türkiye)
Esin Derin ÇİÇEK
(Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Radyoloji Anabilim Dalı, İstanbul, Türkiye)
Yıl: 2021Cilt: 55Sayı: 3ISSN: 1017-995XSayfa Aralığı: 220 - 226İngilizce

31 0
Evaluation of critical shoulder angle and acromion index in patients with anterior shoulder instability and rotator cuff tear
Objective: The aim of this study was to evaluate glenohumeral morphologic differences and their correlation betweenglenohumeral instability and rotator cuff pathology.Methods: Two-hundred radiographs and 100 MRI scans of 100 patients in whom the diagnosis of Anterior Shoulder Instability(Anl) or Rotator Cuff Tear (RCT) was arthroscopically verified were retrospectively identified and included in the study. All thepatients were categorized into two groups: 50 patients with Anl (23 female, 28 male; mean age = 29 ± 7.4) and 50 patients withRCT (28 female, 22 male). Two separate control groups were then formed, one of which included contralateral shoulders ofpatients in the AnI group, and the other consisted of contralateral shoulders of patients in the RCT group. The x-ray and MRIscans were examined by an orthopedic surgeon and a radiologist. The Acromial Index (AI) and the Critical Shoulder Angle (CSA)were measured on true anteroposterior shoulder radiographs; Glenoid Inclination (GI), Glenoid Version (GV), and AcromionAngulation (AA) were measured on MRI.Results: In the AnI group, the measurements were as followed: AI, 0.66 ± 0.03; CSA, 33 ° ± 2.85; GI, 3.4° ± 6.2; GV, 4.1 ± 4.3; andAA, 12.9 ± 8.3. In the RCT group, AI 0.71 ± 0.04; CSA, 36° ± 2.69; GI, 9.1 ± 5; GV, 6.7 ° ± 5.7; and AA, 14.3° ± 8.7. A moderatecorrelation was found between CSA and GI (r = 0.41, P = 0.001) and between AI and GI (r = 0.42, P = 0.014). A weak correlationwas found between AI and GI in the AnI group (r = 0.22, P = 0.001). The inter- and intra-observer intraclass correlationcoefficients were respectively 0.81 and 0.84 for AI, 0.88 and 0.92 for CSA, 0.72 and 0.76 for GI, 0.69 and 0.73 for GV, and 0.72and 0.77 for AA.Conclusion: The results of this study have shown that lower AI, GI, and antevert GV may be associated with AnI. InvestigatingCSA, AI, and GV could be useful for diagnostic evaluation of patients with AnI.Level of Evidence: Level III, Diagnostic Study
DergiAraştırma MakalesiErişime Kapalı
  • 1. Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C. Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint? A radiological study of the critical shoulder angle. Bone Joint J. 2013;95–B(7):935-941. 10.1302/0301-620X.95B7.31028
  • 2. Scheiderer B, Imhoff FB, Johnson JD, et al. Higher critical shoulder angle and acromion ındex are associated with ıncreased retear risk after ısolated supraspinatus tendon repair at short-term follow up. Arthroscopy. 2018;34(10):2748- 2754. 10.1016/j.arthro.2018.05.029
  • 3. İncesoy MA, Yıldız Kİ, Öİ T, et al. The critical shoulder angle, the acromial index, the glenoid version angle and the acromial angulation are associated with rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2020. 10.1007/ s00167-020-06145-8
  • 4. Ames JB, Horan MP, Van der Meijden OA, Leake MJ, Millett PJ. Association between acromial index and outcomes following arthroscopic repair of fullthickness rotator cuff tears. J Bone Joint Surg Am. 2012;94:1862-1869. 10.2106/ JBJS.K.01500
  • 5. Hamid N, Omid R, Yamaguchi K, Steger-May K, Stobbs G, Keener JD. Relationship of radiographic acromial characteristics and rotator cuff disease: A prospective investigation of clinical, radiographic, and sonographic findings. J Shoulder Elbow Surg. 2012;21(10):1289-1298. 10.1016/j.jse.2011.09. 028
  • 6. Moor BK, Kuster R, Osterhoff G, et al. Inclination-dependent changes of the critical shoulder angle significantly influence superior glenohumeral joint stability. Clin Biomech (Bristol Avon). 2016;32:268-273, 10.1016/j.clinbio mech.2015.10.013
  • 7. Graichen H, Koydl P, Zichner L. Effectiveness of glenoid osteotomy in atraumatic posterior instability of the shoulder associated with excessive retroversion and flatness of the glenoid. Int Orthop. 1999;23(2):95-99. 10.1007/ s002640050316
  • 8. Saygi B, Karahan N, Karakus O, Demir AI, Ozkan OC, Soylu-Boy FN. Analysis of glenohumeral morphological factors for anterior shoulder instability and rotator cuff tear by magnetic resonance imaging. J Orthop Surg (Hong Kong). 2018;26(2):2309499018768100. 10.1177/2309499018768100
  • 9. Hohmann E, Tetsworth K. Glenoid version and inclination are risk factors for anterior shoulder dislocation. J Shoulder Elbow Surg. 2015;24(8):1268-1273. 10. 1016/j.jse.2015.03.032
  • 10. Tetreault P, Krueger A, Zurakowski D, Gerber C. Glenoid version and rotatorcuff tears. J Orthop Res. 2004;22(1):202-207. 10.1016/S0736-0266 (03)00116-5
  • 11. García-Mata S, Ovejero AH. Glenohumeral osteometry-scapulometry in anterior shoulder instabilities. Study of one of the static stabilizers through computer tomography. An Sist Sanit Navar. 2011;34(2):175-191.
  • 12. Bigliani LU, Morrison DS, April EW. The morphology of the acromion and rotator cuff impingement. Orthop Trans. 1986;10:228-235.
  • 13. Aoki M, Ishii S, Usui M. The slope of the acromion and rotator cuff impingement. Orthop Trans. 1986;10:228.
  • 14. Mayerhoefer ME, Breitenseher MJ, Wurnig C, Roposch A. Shoulder impingement: Relationship of clinical symptoms and imaging criteria. Clin J Sport Med. 2009;19(2):83-89. 10.1097/JSM.0b013e318198e2e3
  • 15. McGinley JC, Agrawal S, Biswal S. Rotator cuff tears: Association with acromion angulation on MRI. Clin Imaging. 2012;36(6):791-796. 10.1016/j.clinimag. 2012.04.007
  • 16. Vo KV, Hackett DJ, Gee AO, Hsu JE. Classifications in brief: Walch classification of primary glenohumeral osteoarthritis. Clin Orthop Relat Res. 2017;475 (9):2335-2340. 10.1007/s11999-017-5317-6
  • 17. Brolin TJ, Updegrove GF, Horneff JG. Classifications in brief: Hamada classification of massive rotator cuff tears. Clin Orthop Relat Res. 2017;475(11):2819- 2823. 10.1007/s11999-017-5340-7
  • 18. Neer CSII. Impingement lesions. Clin Orthop Relat Res. 1983;173:70-77.
  • 19. Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am. 2006;88(4):800-805. 10.2106/JBJS.D.03042
  • 20. Maurer A, Fucentese SF, Pfirrmann CW, et al. Assessment of glenoid inclination on routine clinical radiographs and computed tomography examinations of the shoulder. J.Shoulder Elbow Surg. 2012;21(8):1096-1103. 10.1016/j.jse. 2011.07.010
  • 21. Dancey C, Reidy J. Statistics Without Maths for Psychology: Using SPSS for Windows. New York: Prentice Hall; 2004.
  • 22. Chalmers PN, Beck L, Granger E, Henninger H, Tashjian RZ. Superior glenoid inclination and rotator cuff tears. J Shoulder Elbow Surg. 2018;27(8):1444-1450. 10.1016/j.jse.2018.02.043
  • 23. Heuberer PR, Plachel F, Willinger L, et al. Critical shoulder angle combined with age predict five shoulder pathologies: A retrospective analysis of 1000 cases. BMC Musculoskelet Disord. 2017;18(1):259. 10.1186/s12891-017-1559-4
  • 24. Griffith JF, Antonio GE, Tong CW, Ming CK. Anterior shoulder dislocation: Quantification of glenoid bone loss with CT. AJR Am J Roentgenol. 2003;180 (5):1423-1430. 10.2214/ajr.180.5.1801423
  • 25. Miyazaki AN, Fregoneze M, Santos PD, et al. Radıographıc study on the acromıon ındex and ıts relatıonshıp wıth rotator cuff tears. Rev Bras Ortop. 2015;45(2):151-154. 10.1590/S0102-36162010000200008
  • 26. Kappe T, Cakir B, Lippacher S, Reichel H, Elsharkawi M. Intraarticular lesions in calcifying tendinitis: Incidence and association with the acromion index. Arch Orthop Trauma Surg. 2011;131(3):325-329. 10.1007/s00402-011-1263-z
  • 27. Miyazaki AN, Itoi E, Sano H, et al. Comparison between the acromion index and rotator cuff tears in the Brazilian and Japanese populations. J Shoulder Elbow Surg. 2011;20(7):1082-1086. 10.1016/j.jse.2011.04.028
  • 28. Kum DH, Kim JH, Park KM, Lee ES, Park YB, Yoo JC. Acromion index in Korean population and its relationship with rotator cuff tears. Clin Orthop Surg. 2017;9 (2):218-222. 10.4055/cios.2017.9.2.218
  • 29. Bjarnison AO, Sørensen TJ, Kallemose T, Barfod KW. The critical shoulder angle is associated with osteoarthritis in the shoulder but not rotator cuff tears: A retrospective case-control study. J Shoulder Elbow Surg. 2017;26(12):2097- 2102. 10.1016/j.jse.2017.06.001
  • 30. Daggett M, Werner B, Collin P, Gauci MO, Chaoui J, Walch G. Correlation between glenoid inclination and critical shoulder angle: A radiographic and computed tomography study. J Shoulder Elbow Surg. 2015;24(12):1948-1953. 10.1016/j.jse.2015.07.013
  • 31. Moor BK, Röthlisberger M, Müller DA, et al. Age, trauma and the critical shoulder angle accurately predict supraspinatus tendon tears. Orthop Traumatol Surg Res. 2014;100(5):489-494. 10.1016/j.otsr.2014.03.022
  • 32. Song JG, Yun SJ, Song YW, Lee SH. High performance of critical shoulder angle for diagnosing rotator cuff tears on radiographs. Knee Surg Sports Traumatol Arthrosc. 2019;27(1):289-298. 10.1007/s00167-018-5247-1
  • 33. Gerber C, Snedeker JG, Baumgartner D, Viehöfer AF. Supraspinatus tendon load during abduction is dependent on the size of the critical shoulder angle: A biomechanical analysis. J Orthop Res. 2014;32(7):952-957. 10.1002/jor.22621
  • 34. Bishop JL, Kline SK, Aalderink KJ, Zauel R, Bey MJ. Glenoid inclination: In vivo measures in rotator cuff tear patients and associations with superior glenohumeral joint translation. J Shoulder Elbow Surg. 2009;18(2):231-236. 10.1016/j.jse. 2008.08.002
  • 35. Kandemir U, Allaire RE, Jolly JT, Debski RE, McMahon PJ. The relationship between the orientation of the glenoid and tears of the rotator cuff. J Bone Joint Surg Br. 2006;88(8):1105-1109. 10.1302/0301-620X.88B8.17732
  • 36. Engelhardt C, Farron A, Becce F, Place N, Pioletti DP, Terrier A. Effects of glenoid inclination and acromion index on humeral head translation and glenoid articular cartilage strain. J Shoulder Elbow Surg. 2017;26(1):157-164. 10.1016/j.jse.2016.05.031
  • 37. Suter T, Gerber Popp A, Zhang Y, Zhang C, Tashjian RZ, Henninger HB. The influence of radiographic viewing perspective and demographics on the critical shoulder angle. J Shoulder Elbow Surg. 2015;24(6):e149-e158. 10.1016/j.jse. 2014.10.021
  • 38. Nakagawa S, Ozaki R, Take Y, Iuchi R, Mae T. Relationship between glenoid defects and hill-sachs lesions in shoulders with traumatic anterior instability. Am J Sports Med. 2015;43(11):2763-2773. 10.1177/0363546515597668
  • 39. Trivedi S, Pomerantz ML, Gross D, Golijanan P, Provencher MT. Shoulder instability in the setting of bipolar (glenoid and humeral head) bone loss: The glenoid track concept. Clin Orthop Relat Res. 2014;472(8):2352-2362. 10.1007/ s11999-014-3589-7
  • 40. Spiegl UJ, Horan MP, Smith SW, Ho CP, Millett PJ. The critical shoulder angle is associated with rotator cuff tears and shoulder osteoarthritis and is better assessed with radiographs over MRI. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2244-2251. 10.1007/s00167-015-3587-7
  • 41. Cherchi L, Ciornohac JF, Godet J, Clavert P, Kempf JF. Critical shoulder angle: Measurement reproducibility and correlation with rotator cuff tendon tears. Orthop Traumatol Surg Res. 2016;102(5):559-562. 10.1016/j.otsr.2016.03.017
  • 42. Li X, Xu W, Hu N, et al. Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis. PLoS One. 2017;12(4):e0176193. 10.1371/journal.pone.0176193
  • 43. Chalmers PN, Salazar D, Steger-May K, Chamberlain AM, Yamaguchi K, Keener JD. Does the critical shoulder angle correlate with rotator cuff tear progression? Clin Orthop Relat Res. 2017;475(6):1608-1617. 10.1007/s11999- 017-5249-1

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