Skip to main content
SpringerLink
Log in

Superior humeral head osteophytes are associated with rotator cuff insufficiency in glenohumeral osteoarthritis: a retrospective analysis

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The primary goal of this study was to investigate whether superior humeral head osteophyte (SHO) size is associated with rotator cuff insufficiency, including rotator cuff tear (RCT), supraspinatus tendon thickness, and fatty infiltration of the rotator cuff muscles.

Methods

Patients  ≥ 18 years who were diagnosed with glenohumeral osteoarthritis were retrospectively reviewed. SHO size was determined by radiograph. MRI measured SHO and RCT presence, type, and size; supraspinatus tendon thickness; and fatty infiltration of rotator cuff musculature.

Results

A total of 461 patients were included. Mean SHO size was 1.93 mm on radiographs and 2.13 mm on MRI. Risk ratio for a RCT was 1.14. For each 1-mm increase in SHO size on radiograph, supraspinatus tendon thickness decreased by 0.20 mm. SHO presence was associated with moderate-to-severe fatty infiltration of the supraspinatus with a risk ratio of 3.16.

Conclusion

SHOs were not associated with RCT but were associated with higher risk of supraspinatus FI and decreased tendon thickness, which could indicate rotator cuff insufficiency.

Level of evidence

IV.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

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

Similar content being viewed by others

Availability of data and materials

The data that support the findings of this study are not openly available due to reasons of privacy. Data are in controlled access data storage at the authors’ institutions.

References

  1. Griffin JW, Hadeed MM, Novicoff WM, Browne JA, Brockmeier SF (2014) Patient age is a factor in early outcomes after shoulder arthroplasty. J Shoulder Elb Surg 23(12):1867–1871. https://doi.org/10.1016/j.jse.2014.04.004

    Article  Google Scholar 

  2. Macías-Hernández SI, Morones-Alba JD, Miranda-Duarte A, Coronado-Zarco R, de LA Soria-Bastida M, Nava Bringas T, Cruz-Medina E, Olascoaga-Gómez A, Tallabs-Almazan LV, Palencia C (2017) Glenohumeral osteoarthritis: overview, therapy, and rehabilitation. Disabil Rehabilit 39(16):1674–1682. https://doi.org/10.1080/09638288.2016.1207206

    Article  Google Scholar 

  3. Brox JI, Lereim P, Merckoll E, Finnanger AM (2003) Radiographic classification of glenohumeral arthrosis. Acta Orthop Scand 74(2):186–189. https://doi.org/10.1080/00016470310013932

    Article  PubMed  Google Scholar 

  4. Millett PJ, Schoenahl JY, Allen MJ, Motta T, Gaskill TR (2013) An association between the inferior humeral head osteophyte and teres minor fatty infiltration: evidence for axillary nerve entrapment in glenohumeral osteoarthritis. J Shoulder Elb Surg 22(2):215–221. https://doi.org/10.1016/j.jse.2012.05.030

    Article  Google Scholar 

  5. Chalmers PN, Miller M, Wheelwright JC, Kawakami J, Henninger HB, Tashjian RZ (2021) Acromial and glenoid morphology in glenohumeral osteoarthritis: a three-dimensional analysis. JSES Int 5(3):398–405. https://doi.org/10.1016/j.jseint.2021.01.006

    Article  PubMed  PubMed Central  Google Scholar 

  6. Koh KH, Han KY, Yoon YC, Lee SW, Yoo JC (2013) True anteroposterior (Grashey) view as a screening radiograph for further imaging study in rotator cuff tear. J Shoulder Elb Surg 22(7):901–907. https://doi.org/10.1016/j.jse.2012.09.015

    Article  Google Scholar 

  7. Edwards TB, Boulahia A, Kempf JF, Boileau P, Nemoz C, Walch G (2002) The influence of rotator cuff disease on the results of shoulder arthroplasty for primary osteoarthritis: results of a multicenter study. J Bone Jt Surg Am 84(12):2240–2248. https://doi.org/10.2106/00004623-200212000-00018

    Article  Google Scholar 

  8. Norris TR, Iannotti JP (2002) Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. J Shoulder Elb Surg 11(2):130–135. https://doi.org/10.1067/mse.2002.121146

    Article  Google Scholar 

  9. Levy DM, Abrams GD, Harris JD, Bach BR Jr, Nicholson GP, Romeo AA (2016) Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: a systematic review. Int J Shoulder Surg 10(2):78–84. https://doi.org/10.4103/0973-6042.180720

    Article  PubMed  PubMed Central  Google Scholar 

  10. Young AA, Walch G, Pape G, Gohlke F, Favard L (2012) Secondary rotator cuff dysfunction following total shoulder arthroplasty for primary glenohumeral osteoarthritis: results of a multicenter study with more than five years of follow-up. J Bone Jt Surg Am 94:685–693. https://doi.org/10.2106/JBJS.J.00727

    Article  Google Scholar 

  11. Bohonos CJ, Russell SP, Morrissey DI (2021) CT versus MRI planning for reverse geometry total shoulder arthroplasty. J Orthop 28:21–25. https://doi.org/10.1016/j.jor.2021.10.003

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cancienne JM, Dempsey IJ, Garrigues GE, Cole BJ, Brockmeier SF, Werner BC (2021) Trends and impact of three-dimensional preoperative imaging for anatomic total shoulder arthroplasty. Shoulder Elb 13(4):380–387. https://doi.org/10.1177/1758573220908865

    Article  Google Scholar 

  13. Dekker TJ, Steele JR, Vinson EV, Garrigues GE (2019) Current peri-operative imaging concepts surrounding shoulder arthroplasty. Skelet Radiol 48(10):1485–1497. https://doi.org/10.1007/s00256-019-03183-3

    Article  Google Scholar 

  14. Alolabi B, Youderian AR, Napolitano L, Szerlip BW, Evans PJ, Nowinski RJ, Ricchetti ET, Iannotti JP (2014) Radiographic assessment of prosthetic humeral head size after anatomic shoulder arthroplasty. J Shoulder Elb Surg 23(11):1740–1746. https://doi.org/10.1016/j.jse.2014.02.013

    Article  Google Scholar 

  15. 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 Elb Surg 8(6):599–605. https://doi.org/10.1016/s1058-2746(99)90097-6

    Article  CAS  Google Scholar 

  16. Doğan NÖ (2018) Bland-Altman analysis: a paradigm to understand correlation and agreement. Turk J Emerg Med 18(4):139–141. https://doi.org/10.1016/j.tjem.2018.09.001

    Article  PubMed  PubMed Central  Google Scholar 

  17. Moran GW (1984) Locally-Weighted-Regression Scatter-Plot Smoothing (LOWESS): a graphical exploratory data analysis technique. Naval Postgraduate School, Monterey

    Google Scholar 

  18. Pearsall AW, Bonsell S, Heitman RJ, Helms CA, Osbahr D, Speer KP (2003) Radiographic findings associated with symptomatic rotator cuff tears. J Shoulder Elb Surg 12(2):122–127. https://doi.org/10.1067/mse.2003.19

    Article  Google Scholar 

  19. Chuang H-C, Hong C-K, Hsu K-L, Kuan F-C, Chiang C-H, Chen Y, Su W-R (2020) Radiographic greater tuberosity spurs and narrow acromiohumeral intervals are associated with advanced retraction of the supraspinatus tendon in patients with symptomatic rotator cuff tears. JSES Int 5(1):77–82. https://doi.org/10.1016/j.jseint.2020.09.015

    Article  PubMed  PubMed Central  Google Scholar 

  20. Chuang H-C, Hong C-K, Hsu K-L, Kuan F-C, Lin C-L, Su W-R (2019) The radiographic morphology of the greater tuberosity is associated with muscle degeneration in patients with symptomatic rotator cuff tears. J Shoulder Elb Surg 28(10):1964–1970. https://doi.org/10.1016/j.jse.2019.03.010

    Article  Google Scholar 

  21. Hamid N, Omid R, Yamaguchi K, Steger-May K, Stobbs G, Keener JD (2012) Relationship of radiographic acromial characteristics and rotator cuff disease: a prospective investigation of clinical, radiographic, and sonographic findings. J Shoulder Elb Surg 21(10):1289–1298. https://doi.org/10.1016/j.jse.2011.09.028

    Article  Google Scholar 

  22. Sayed-Noor AS, Pollock R, Elhassan BT, Kadum B (2018) Fatty infiltration and muscle atrophy of the rotator cuff in stemless total shoulder arthroplasty: a prospective cohort study. J Shoulder Elb Surg 27(6):976–982. https://doi.org/10.1016/j.jse.2017.12.021

    Article  Google Scholar 

  23. Moineau G, McClelland WB, Trojani C, Rumian A, Walch G, Boileau P (2012) Prognostic factors and limitation of anatomic shoulder arthroplasty for the treatment of posttraumatic cephalic collapse or necrosis (type-1 proximal humeral fracture sequelae). J Bone Jt Surg Am 94(23):2186–2194. https://doi.org/10.2106/JBJS.J.00412

    Article  Google Scholar 

  24. Edwards GA, McCann PA, Whitehouse MR, Wakeley CJ, Sarangi PP (2020) The influence of fatty infiltration and muscle atrophy of the rotator cuff muscles on midterm functional outcomes in total shoulder resurfacing at six years follow up. Shoulder Elb 12(2):91–98. https://doi.org/10.1177/1758573218811655

    Article  Google Scholar 

  25. Lapner PLC, Jiang L, Zhang T, Athwal GS (2015) Rotator cuff fatty infiltration and atrophy are associated with functional outcomes in anatomic shoulder arthroplasty. Clin Orthop Relat Res 473(2):674–682. https://doi.org/10.1007/s11999-014-3963-5

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA

    Brenton R. Jennewine, Nicholas F. James, William P. Polio, Thomas W. Throckmorton, David L. Bernholt, Frederick M. Azar & Tyler J. Brolin

  2. Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, USA

    Abu Mohd Naser

  3. Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL, USA

    Micah J. Nieboer & Bradley S. Schoch

Authors
  1. Brenton R. Jennewine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicholas F. James
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William P. Polio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Abu Mohd Naser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Micah J. Nieboer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bradley S. Schoch
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Thomas W. Throckmorton
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David L. Bernholt
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Frederick M. Azar
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tyler J. Brolin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tyler J. Brolin.

Ethics declarations

Conflict of interest

The authors did not receive support from any organization for the supported work. The authors report no conflicts of interest.

Ethical approval

This study was approved by the Institutional Review Board of the University of Tennessee Health Science College and complies with all applicable laws and ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jennewine, B.R., James, N.F., Polio, W.P. et al. Superior humeral head osteophytes are associated with rotator cuff insufficiency in glenohumeral osteoarthritis: a retrospective analysis. Eur J Orthop Surg Traumatol 34, 893–900 (2024). https://doi.org/10.1007/s00590-023-03727-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-023-03727-3

Keywords

Search

Navigation