Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 7, pp 2200–2205 | Cite as

Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears

  • Maurice BalkeEmail author
  • Dennis Liem
  • Oliver Greshake
  • Juergen Hoeher
  • Bertil Bouillon
  • Marc Banerjee



Distinct characteristics of acromial morphology seem to be one factor for the development of degenerative supraspinatus tendon tears. Thus, it is questionable whether patients with traumatic tendon tears also present these parameters. The hypothesis of the present study was that the acromial morphology of patients with degenerative supraspinatus tendon tears differs from patients with traumatic tears.


One hundred and thirty-six patients that were treated by arthroscopic rotator cuff repair from 2010 to 2013 were included in this study. Seventy-two patients had degenerative (group 1), and 64 had traumatic (group 2) supraspinatus tendon tears. On preoperative radiographs the Bigliani type, acromial slope, acromiohumeral (AH) distance, lateral acromial angle (LAA), acromion index (AI), and critical shoulder angle (CSA) were measured. Medians of these parameters as well as of age of both groups were compared using the t test.


The percentaged distribution of the Bigliani type differed (group 1 vs. 2: type 1: 18/38, type 2: 56/55, type 3: 26/8). All parameters showed significant differences between degenerative and traumatic tears. Slope: 21.2° (SD 7.6°) versus 19.2° (SD 7.9°, p = 0.026), AH distance: 8.4 mm (SD 2.3 mm) versus 9.9 mm (SD 1.9 mm, p = 0.0006), LAA: 77.0° (SD 4.0°) versus 82.5° (SD 4.7°, p < 0.0001), AI: 0.77 (SD 0.07) versus 0.73 (0.06, p = 0.0239), and CSA: 36.8° (SD 3.6°) versus 35.3° (SD 2.9°, p = 0.007). An LAA <70° or an AH distance of <5 mm only occurred in degenerative tears. Patients with degenerative tears were significantly older (60 vs. 54 years).


The hypothesis that the acromial morphology of patients with degenerative supraspinatus tendon tears differs from patients with traumatic tears was confirmed. Shoulders with degenerative tears show a narrower subacromial space and a larger lateral extension as well as a steeper angulation of the acromion than with traumatic tears. Thus, the results of this study support the theory of external impingement as a cause for degenerative rotator cuff tears.

Level of evidence



Shoulder trauma Rotator cuff tear Acromial morphology Subacromial decompression Bigliani 


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2014

Authors and Affiliations

  • Maurice Balke
    • 1
    • 3
    Email author
  • Dennis Liem
    • 2
  • Oliver Greshake
    • 1
  • Juergen Hoeher
    • 1
  • Bertil Bouillon
    • 3
  • Marc Banerjee
    • 3
  1. 1.Sportsclinic Cologne, Cologne-Merheim Medical CenterUniversity of Witten-HerdeckeCologneGermany
  2. 2.Department of Orthopaedic SurgeryUniversity Hospital MuensterMünsterGermany
  3. 3.Department of Trauma and Orthopaedic Surgery, Cologne-Merheim Medical CenterUniversity of Witten-HerdeckeCologneGermany

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