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Subacromial Impingement

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Rotator Cuff Tear

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Abstract

Since the middle of the last century, many studies have been performed with the aim to identify factors predisposing to cuff tendon tear. Since it was known that the acromion could have different shapes and different degrees of inclination, it has been simple to attribute these acromion features the responsibility of a pathological narrowness of the subacromial space. In fact, studies conducted between 1943 and 1969 [1–8] concluded that cuff tendon impingement against the antero-inferior margin of the acromion was the determining cause of tendon injury. Despite the fact that this belief was almost universal, the proposed treatments were discordant; Armstrong [3], Watson-Jones [4], Hammond [5], and Diamonds [6, 7] suggested performing total acromionectomy in case of symptomatic rotator cuff tear; Smith-Petersen et al. [1] and McLaughlin [2] suggested the removal of the lateral margin of the acromion because they believed that cuff tendons could rub only against this acromial portion.

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References

  1. Smith-Petersen MN, Aufranc OE, Larson CB (1943) Useful surgical procedures for rheumatoid arthritis involving joints of the upper extremity. Arch Surg 46:764–770

    Article  Google Scholar 

  2. McLaughlin HL (1944) Lesions of the musculotendinous cuff of the shoulder. I. The exposure and treatment of tears with retraction. J Bone Joint Surg 26:31–51

    Google Scholar 

  3. Armstrong JR (1949) Excision of the acromion in treatment of the supraspinatus syndrome: report of ninety-five excisions. J Bone Joint Surg Br 31:436–442

    Article  Google Scholar 

  4. Watson-Jones R (1960) Fractures and joint injuries. Williams & Wilkins, Baltimore, pp 449–451

    Google Scholar 

  5. Hammond G (1962) Complete acromionectomy in the treatment of chronic tendinitis of the shoulder. J Bone Joint Surg Am 44(3):494–504

    Article  PubMed  Google Scholar 

  6. Hammond G (1971) Complete acromionectomy in the treatment of chronic tendinitis of the shoulder. A follow-up of ninety operations of eighty-seven patients. J Bone Joint Surg Am 53:173–180

    Article  CAS  PubMed  Google Scholar 

  7. Diamond B (1964) The obstructing acromion. Charles C Thomas, Springfield, Ill

    Google Scholar 

  8. Moseley HF (1969) Shoulder lesions. E & S Livingstone, Edinburgh

    Google Scholar 

  9. Neer CS II (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder. A preliminary report. J Bone Joint Surg Am 54:41–50

    Article  PubMed  Google Scholar 

  10. Neer CS II (1983) Impingement lesions. Clin Orthop Relat Res 173:70–77

    Google Scholar 

  11. Hawkins RJ, Kennedy JC (1980) Impingement syndrome in athletes. Am J Sports Med 8(3):151–158

    Article  CAS  PubMed  Google Scholar 

  12. Jackson DW (1976) Chronic rotator cuff impingement in the throwing athlete. Am J Sports Med 4(6):231–240

    Article  CAS  PubMed  Google Scholar 

  13. Kessel L, Watson M (1977) The painful arc syndrome. Clinical classifi cation as a guide to management. J Bone Joint Surg Br 59(2):166–172

    CAS  PubMed  Google Scholar 

  14. Penny JN, Welsh RP (1981) Shoulder impingement syndromes in athletes and their surgical management. Am J Sports Med 9(1):11–15

    Article  CAS  PubMed  Google Scholar 

  15. Jens J (1964) The role of the subscapularis muscle in recurring dislocation of the shoulder (abstract). J Bone Joint Surg Br 34:780

    Google Scholar 

  16. Ha’eri GB, Orth MC, Wiley AM (1982) Shoulder impingement syndrome. Clin Orthop Relat Res 168:128–132

    Google Scholar 

  17. Neviaser TJ, Neviaser RJ, Neviaser JS (1982) The four-in-one arthroplasty for the painful arc syndrome. Clin Orthop Relat Res 163:107–112

    Google Scholar 

  18. Pujadas GM (1970) Coraco-acromial ligament syndrome. J Bone Joint Surg Am 52:1261–1262

    Google Scholar 

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

    Google Scholar 

  20. Morrison DS, Bigliani LU (1987) The clinical significance of variations in acromial morphology. Orthop Trans 11:234

    Google Scholar 

  21. 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. J Bone Joint Surg Am 70:1224–1230

    Article  CAS  PubMed  Google Scholar 

  22. Ogata S, Uhthoff HK (1990) Acromial enthesopathy and rotator cuff tear. Clin Orthop Relat Res 254:39–48

    Google Scholar 

  23. Epstein RE, Schweitzer ME, Frieman BG, Fenlin JM, Mitchell DG (1993) Hooked acromion: prevalence on MR images of painful shoulders. Radiology 187:479–481

    Article  CAS  PubMed  Google Scholar 

  24. Gagey N, Ravaud E, Lassau JP (1993) Anatomy of the acromial arch: correlation of anatomy and magnetic resonance imaging. Surg Radiol Anat 15:63–70

    Article  CAS  PubMed  Google Scholar 

  25. Chun JM, Yoo HW (1994) Incidence of acromial spur (abstract). J Shoulder Elbow Surg 3(Suppl):S20

    Google Scholar 

  26. Farley TE, Neumann CH, Steinbach LS, Petersen SA (1994) The coracoacromial arch: MR evaluation and correlation with rotator cuff pathology. Skeletal Radiol 23:641–645

    Article  CAS  PubMed  Google Scholar 

  27. Getz JD, Recht MP, Piraino DW, Schils JP, Latimer BM, Jellema LM, Obuchowski NA (1996) Acromial morphology: relation to sex, age, symmetry, and subacromial enthesophytes. Radiology 199:737–742

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  29. Bigliani LU, Levine WN (1997) Current concepts review—subacromial impingement syndrome. J Bone Joint Surg Am 79:1854–1868

    Article  CAS  PubMed  Google Scholar 

  30. Chambler AFW, Emery RJH (1997) Acromial morphology: the enigma of terminology. Knee Surg Sports Traumatol Arthrosc 5:268–272

    Article  CAS  PubMed  Google Scholar 

  31. Hirano M, Ide J, Takagi K (2002) Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluation. J Shoulder Elbow Surg 11:576–578

    Article  PubMed  Google Scholar 

  32. Nastis K, Tsikararas P, Totlis T, Gigis I, Skandalakis P, Appel HJ et al (2007) Correlation between the four types of acromion and the existence of enthesophytes: a study on 423 dried scapulas and review of the literature. Clin Anat 20:267–272

    Article  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  34. Shah NN, Bayliss NC, Malcolm A (2001) Shape of the acromion: congenital or acquired—a macroscopic, radiographic, and microscopic study of acromion. J Shoulder Elbow Surg 10:309–316

    Article  CAS  PubMed  Google Scholar 

  35. Worland RL, Lee D, Orozco CG, SozaRex F, Keenan J (2003) Correlation of age, acromial morphology, and rotator cuff tear pathology diagnosed by ultrasound in asymptomatic patients. J South Orthop Assoc 12:23–26

    CAS  PubMed  Google Scholar 

  36. Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC (1991) The relationship of acromial architecture to rotator cuff disease. Clin Sports Med 10:823–838

    CAS  PubMed  Google Scholar 

  37. Rothman RH, Parke WW (1965) The vascular anatomy of the rotator cuff. Clin Orthop Relat Res 41:176–186

    Article  CAS  PubMed  Google Scholar 

  38. Wang JC, Shapiro MS (1997) Changes in acromial morphologywith age. J Shoulder Elbow Surg 6:55–59

    Article  CAS  PubMed  Google Scholar 

  39. Goldberg BA, Lippitt SB, Matsen FA III (2001) Improvement in comfort and function after cuff repair without acromioplasty. Clin Orthop 390:142–150

    Article  Google Scholar 

  40. McCallister WV, Parsons IM, Titelman RM et al (2005) Open rotator cuff repair without acromioplasty. J Bone Joint Surg Am 87(6):1278–1283

    PubMed  Google Scholar 

  41. Gartsman GM, O’Connor DP (2004) Arthroscopic rotator cuff repair with and without arthroscopic subacromial decompression: prospective, randomized study of one-year outcomes. J Shoulder Elbow Surg 13:424–426

    Article  PubMed  Google Scholar 

  42. Milano G, Grasso A, Salvatore M, Zarelli D, Deriu L, Fabbriciani C (2007) Arthroscopic rotator cuff repair with and without subacromial decompression: a prospective randomized study. Arthroscopy 23:81–88

    Article  PubMed  Google Scholar 

  43. Shin SJ, Oh JH, Chung SW, Song MH (2012) The efficacy of acromioplasty in the arthroscopic repair of small- to medium-sized rotator cuff tears without acromial spur: prospective comparative study. Arthroscopy 28(5):628–635

    Article  PubMed  Google Scholar 

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

    Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  46. Oh JH, Kim JY, Lee HK, Choi JA (2010) Classification and clinical significance of acromial spur in rotator cuff tear: heel-type spur and rotator cuff tear. Clin Orthop Relat Res 468:1542–1550

    Article  PubMed  Google Scholar 

  47. Mahakkanukrauh P, Surin P (2003) Prevalence of osteophytes associated with the acromion and acromioclavicular joint. Clin Anat 16:506–510

    Article  PubMed  Google Scholar 

  48. Gumina S, Arceri V, Fagnani C, Venditto T, Catalano C, Candela V, Nisticò L (2015) Subacromial space width: does overuse or genetics play a greater role in determining It? An MRI study on elderly twins. J Bone Joint Surg Am 97(20):1647–1652. doi:10.2106/JBJS.O.00379

    Article  CAS  PubMed  Google Scholar 

  49. H Snieder, X Wang, AJ MacGregor - eLS, 2010.

    Google Scholar 

  50. Jain NB, Higgins LD, Losina E, Collins J, Blazar PE, Katz JN (2014) Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. BMC Musculoskelet Disord 15:4

    Article  PubMed  PubMed Central  Google Scholar 

  51. Frost P, Andersen JH (1999) Shoulder impingement syndrome in relation to shoulder intensive work. Occup Environ Med 56:494–498

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. van Rijn RM, Huisstede BM, Koes BW, Burdorf A (2010) Associations between work-related factors and specific disorders of the shoulder—a systematic review of the literature. Scand J Work Environ Health 36:189–201

    Article  PubMed  Google Scholar 

  53. Roquelaure Y, Bodin J, Ha C, Petit Le Manac’h A, Descatha A, Chastang JF, Leclerc A, Goldberg M, Imbernon E (2011) Personal, biomechanical, and psychosocial risk factors for rotator cuff syndrome in a working population. Scand J Work Environ Health 37:502–511

    Article  PubMed  Google Scholar 

  54. Svendsen SW, Dalbøge A, Andersen JH, Thomsen JF, Frost P (2013) Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures: a longitudinal study. Scand J Work Environ Health 39:568–577

    Article  PubMed  Google Scholar 

  55. Harryman DT 2nd, Sidles JA, Clark JM, McQuade KJ, Gibb TD, Matsen FA 3rd (1990) Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am 72:1334–1343

    Article  PubMed  Google Scholar 

  56. Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology Part III: the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy 19:641–661

    Article  PubMed  Google Scholar 

  57. Grossman MG, Tibone JE, McGarry MH, Schneider DJ, Veneziani S, Lee TQ (2005) A cadaveric model of the throwing shoulder: a possible etiology of superior labrum anterior-to-posterior lesions. J Bone Joint Surg Am 87:824–831

    PubMed  Google Scholar 

  58. Seitz AL, McClure PW, Finucane S, Boardman ND 3rd, Michener LA (2011) Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both? Clin Biomech (Bristol, Avon) 26:1–12

    Article  Google Scholar 

  59. Sugaya H, Maeda K, Matsuki K, Moriishi J (2007) Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am 89:953–960

    PubMed  Google Scholar 

  60. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 8(6):599–605

    Article  CAS  PubMed  Google Scholar 

  61. Rathbun JB, Macnab I (1970) The microvascular pattern of the rotator cuff. J Bone Joint Surg Br 52:540–553

    CAS  PubMed  Google Scholar 

  62. Glass DJ (2003) Signalling pathways that mediate skeletal muscle hypertrophy and atrophy. Nat Cell Biol 5:87

    Article  CAS  PubMed  Google Scholar 

  63. Kandarian SC, Jackman RW (2006) Intracellular signaling during skeletal muscle atrophy. Muscle Nerve 33:155

    Article  CAS  PubMed  Google Scholar 

  64. Tyml K, Mathieu-Costello O (2001) Structural and functional changes in the microvasculature of disused skeletal muscle. Front Biosci 6:d45–52

    Article  CAS  PubMed  Google Scholar 

  65. Carry MR, Ringel SP, Starcevich JM (1986) Distribution of capillaries in normal and diseased human skeletal muscle. Muscle Nerve 9:445–454

    Article  CAS  PubMed  Google Scholar 

  66. Jozsa L, Kannus P, Thoring J, Reffy A, Jarvinen M, Kvist M (1990) The effect of tenotomy and immobilization on intramuscular connective tissue. J Bone Joint Surg 72B:293–297

    Google Scholar 

  67. Borisov AB, Huang S, Carlson BM (2000) Remodeling of the vascular bed and progressive loss of capillaries in denervated skeletal muscle. Anat Rec 258:292–304

    Article  CAS  PubMed  Google Scholar 

  68. Papakonstantinou MK, Pan WR, le Roux CM, Richardson MD (2012) Arterial supply of the tendinous rotator cuff insertions: an anatomical study. ANZ J Surg 82:928–934

    Article  PubMed  Google Scholar 

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  1. Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, Sapienza, University of Rome, Rome, Italy

    Stefano Gumina

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    Stefano Gumina

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Gumina, S. (2017). Subacromial Impingement. In: Gumina, S. (eds) Rotator Cuff Tear. Springer, Cham. https://doi.org/10.1007/978-3-319-33355-7_14

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  • DOI: https://doi.org/10.1007/978-3-319-33355-7_14

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