Skip to main content

Advertisement

Log in

Can a high acromion index predict rotator cuff tears?

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to identify the relationship between an acromion index (AI) and the size of a rotator cuff tear. The hypothesis of our study was that an AI will be higher in patients with a full-thickness tear than in patients with a partial-thickness articular-side tear, and that it can be used as a predictor for the size of a rotator cuff tear.

Methods

We included 284 patients who had been diagnosed with rotator cuff tears and had undergone arthroscopic rotator cuff repair at our institute. All patients were divided into five distinct groups (partial-thickness articular side tear, and four subgroups of full-thickness tears) depending on the size of the rotator cuff tear on arthroscopy. In each patient, an AI was measured on the pre-operative oblique coronal MR images and then analysed to determine the difference between groups.

Results

There were statistically significant differences between the partial-thickness articular side rotator cuff tear and large-to-massive rotator cuff tear groups (p < 0.01), and the mean value of an AI was highest in the large-sized full-thickness tear group. The AI of the partial-thickness articular-side rotator cuff tear group was statistically different from the large-to-massive rotator cuff tear groups.

Conclusions

The AI can be a predictor which can differentiate a partial-thickness articular-side tear and a large-to-massive rotator cuff tear pre-operatively. However the AI could not provide useful guidance on predicting the differences in tear size in full-thickness tear patients. We suggest that a high AI can be one of the associated factors for progression to large-to-massive rotator cuff tears in a rotator cuff disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Neer CS 2nd (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54(1):41–50

    PubMed  Google Scholar 

  2. Bigliani LU, Morrison DS, April EW (1986) The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans 10:228

    Google Scholar 

  3. Aoki M, Ishii S, Usui M (1986) The slope of the acromion and rotator cuff impingement. Orthop Trans 10:228

    Google Scholar 

  4. Banas MP, Miller RJ, Totterman S (1995) Relationship between the lateral acromion angle and rotator cuff disease. J Should Elbow Surg 4(6):454–461

    Article  CAS  Google Scholar 

  5. Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C (2006) Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am 88(4):800–805. doi:10.2106/JBJS.D.03042

    Article  PubMed  Google Scholar 

  6. Torrens C, Lopez JM, Puente I, Caceres E (2007) The influence of the acromial coverage index in rotator cuff tears. J Should Elbow Surg 16(3):347–351. doi:10.1016/j.jse.2006.07.006

    Article  Google Scholar 

  7. Zumstein MA, Jost B, Hempel J, Hodler J, Gerber C (2008) The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg Am 90(11):2423–2431. doi:10.2106/JBJS.G.00677

    Article  PubMed  Google Scholar 

  8. DeOrio JK, Cofield RH (1984) Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 66(4):563–567

    PubMed  CAS  Google Scholar 

  9. Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S (1988) Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am 70(8):1224–1230

    PubMed  CAS  Google Scholar 

  10. Chansky HA, Iannotti JP (1991) The vascularity of the rotator cuff. Clin Sports Med 10(4):807–822

    PubMed  CAS  Google Scholar 

  11. Nixon JE, DiStefano V (1975) Ruptures of the rotator cuff. Orthop Clin North Am 6(2):423–447

    PubMed  CAS  Google Scholar 

  12. Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC (1991) Relationship of acromial architecture and diseases of the rotator cuff. Orthopade 20(5):302–309

    PubMed  CAS  Google Scholar 

  13. Toivonen DA, Tuite MJ, Orwin JF (1995) Acromial structure and tears of the rotator cuff. J Should Elbow Surg 4(5):376–383

    Article  CAS  Google Scholar 

  14. Hayes PR, Flatow EL (2002) Attrition sign in impingement syndrome. Arthroscopy 18(9):E44

    Article  PubMed  Google Scholar 

  15. Ouellette H, Labis J, Bredella M, Palmer WE, Sheah K, Torriani M (2008) Spectrum of shoulder injuries in the baseball pitcher. Skeletal Radiol 37(6):491–498. doi:10.1007/s00256-007-0389-0

    Article  PubMed  Google Scholar 

  16. Neer CS 2nd (1983) Impingement lesions. Clin Orthop Relat Res 173:70–77

    PubMed  Google Scholar 

  17. Hirano M, Ide J, Takagi K (2002) Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluation. J Should Elbow Surg 11(6):576–578. doi:10.1067/mse.2002.127097

    Article  Google Scholar 

  18. Nicholson GP, Goodman DA, Flatow EL, Bigliani LU (1996) The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Should Elbow Surg 5(1):1–11

    Article  CAS  Google Scholar 

  19. Ogawa K, Yoshida A, Inokuchi W, Naniwa T (2005) Acromial spur: relationship to aging and morphologic changes in the rotator cuff. J Should Elbow Surg 14(6):591–598. doi:10.1016/j.jse.2005.03.007

    Article  Google Scholar 

  20. Tucker TJ, Snyder SJ (2004) The keeled acromion: an aggressive acromial variant–a series of 20 patients with associated rotator cuff tears. Arthroscopy 20(7):744–753. doi:10.1016/j.arthro.2004.06.018

    Article  PubMed  Google Scholar 

  21. Dogan M, Cay N, Tosun O, Karaoglanoglu M, Bozkurt M (2011) Glenoid axis is not related with rotator cuff tears-a magnetic resonance imaging comparative study. Int Orthop. doi:10.1007/s00264-011-1356-x

  22. Anderson K, Bowen MK (1999) Spur reformation after arthroscopic acromioplasty. Arthroscopy 15(7):788–791

    Article  PubMed  CAS  Google Scholar 

  23. Panni AS, Milano G, Lucania L, Fabbriciani C, Logroscino CA (1996) Histological analysis of the coracoacromial arch: correlation between age-related changes and rotator cuff tears. Arthroscopy 12(5):531–540

    Article  PubMed  CAS  Google Scholar 

  24. Bonsell S, Pearsall AWT, Heitman RJ, Helms CA, Major NM, Speer KP (2000) The relationship of age, gender, and degenerative changes observed on radiographs of the shoulder in asymptomatic individuals. J Bone Joint Surg Br 82(8):1135–1139

    Article  PubMed  CAS  Google Scholar 

  25. Kappe T, Cakir B, Lippacher S, Reichel H, Elsharkawi M (2011) Intraarticular lesions in calcifying tendinitis: incidence and association with the acromion index. Arch Orthop Trauma Surg 131(3):325–329. doi:10.1007/s00402-011-1263-z

    Article  PubMed  Google Scholar 

  26. Iannotti JP, Zlatkin MB, Esterhai JL, Kressel HY, Dalinka MK, Spindler KP (1991) Magnetic resonance imaging of the shoulder. Sensitivity, specificity, and predictive value. J Bone Joint Surg Am 73(1):17–29

    PubMed  CAS  Google Scholar 

  27. Ko JY, Huang CC, Chen WJ, Chen CE, Chen SH, Wang CJ (2006) Pathogenesis of partial tear of the rotator cuff: a clinical and pathologic study. J Should Elbow Surg 15(3):271–278. doi:10.1016/j.jse.2005.10.013

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jae Hwa Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, J.R., Ryu, K.J., Hong, I.T. et al. Can a high acromion index predict rotator cuff tears?. International Orthopaedics (SICOT) 36, 1019–1024 (2012). https://doi.org/10.1007/s00264-012-1499-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-012-1499-4

Keywords

Navigation