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Arthroscopic lateral acromion resection (ALAR) optimizes rotator cuff tear relevant scapula parameters

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

An Erratum to this article was published on 23 May 2016

Abstract

Background

The acromion index (AI), critical shoulder angle (CSA) and lateral acromion angle (LAA) are predictive for degenerative rotatory cuff tears. Their unfavorable values are associated with a suboptimal deltoid force vector. The aim of this study was to evaluate whether an optimization of the radiological parameters could be achieved through a specific arthroscopic lateral acromion resection (ALAR).

Materials and methods

The procedure was performed in eight fresh frozen cadaver shoulders. True a.p. and axial radiographs were taken before and after the intervention for radiological evaluation. The anterior and posterior acromion edges were marked with a spinal needle. Then 1 cm of the lateral acromion was resected with a 5.0 acromionizer (Arthrex Inc., Naples, FL, USA) beginning from the anterior aspect. The resection was completed over the total width of 1 cm from anterior to posterior. Finally the deltoid insertion was dissected via an open approach to ensure its integrity. The fluoroscopy images were evaluated regarding the pre- and postinterventional parameters AI, CSA and LAA.

Results

After the intervention, the mean AI could be significantly reduced from 0.62 ± 0.11 to 0.40 ± 0.15 (p = 0.012). Also the mean CSA was significantly reduced from 35.0° ± 7.65° to 25.12° ± 8.29° (p = 0.018). The LAA could not be significantly changed (76.5° ± 14.02° vs. 82.13 ± 8.93; p = 0.107). There was no injury to the deltoid insertion.

Conclusion

The radiographic parameters AI und CSA can be optimized significantly by ALAR without macroscopic discontinuity of the deltoid insertion.

Level of evidence

Level IV, case series without comparison group.

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Acknowledgments

The authors would like to thank Arthrex® Inc. (Naples, Florida) for the support during the study.

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Authors and Affiliations

  1. Sporthopaedicum Regensburg, Hildegard-von-Bingen-Str. 1, 93053, Regensburg, Germany

    Burak Altintas, Max Kääb & Stefan Greiner

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  1. Burak Altintas
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  2. Max Kääb
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  3. Stefan Greiner
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Correspondence to Stefan Greiner.

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Conflict of interest

The authors report the following potential conflicts of interest or source of funding: S. Greiner and M. Kääb are consultants for Arthrex®. The authors, their immediate families, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Altintas, B., Kääb, M. & Greiner, S. Arthroscopic lateral acromion resection (ALAR) optimizes rotator cuff tear relevant scapula parameters. Arch Orthop Trauma Surg 136, 799–804 (2016). https://doi.org/10.1007/s00402-016-2431-y

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  • DOI: https://doi.org/10.1007/s00402-016-2431-y

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