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The association between a low critical shoulder angle and SLAP lesions

Knee Surgery, Sports Traumatology, Arthroscopy volume 27, pages 3944–3951 (2019)Cite this article

Abstract

Purpose

To evaluate the critical shoulder angle (CSA), acromion index (AI) and further acromion parameters in patients with isolated SLAP lesions compared with patients without SLAP lesions.

Methods

Between 2012 and 2016, the CSA, AI, lateral acromion angle (LAA) and acromion slope (AS) were radiologically examined in consecutive patients > 18 years having had a shoulder arthroscopy with isolated SLAP lesion types II–IV. These were compared to controls without SLAP lesions and without (control group I) or with (control group II) complete supraspinatus tendon (SSP) tears.

Results

75/103 patients with isolated SLAP lesion types II–IV with a mean age of 46.5 years (± 13.0, 18.1–76.3) were analyzed, 61% of them being male. For control, n = 211 consecutive patients (47% male) with an intact SSP and SLAP complex and a mean age of 52.3 years (± 15.0, 18.6–88.4) and n = 115 patients (60% male) with an intact SLAP complex but complete SSP tears, mean age 66.6 years (± 9.3, 44.7–87.9) were examined. The CSA in SLAP patients was 29.6° (± 3.5, 21.0–38.0), 33.8° (± 3.7, 25.1–46.9) in no SLAP and no SSP (p < 0.001) and 36.7° (± 3.6, 29.1–46.6) in no SLAP but SSP (p < 0.001). The area under the curve (AUC) for CSA was 0.83 for SLAP lesions resulting in a probability of 83% for patients with SLAP lesion to be associated with a specific CSA.

Conclusions

Isolated SLAP lesion types II–IV are associated with a low CSA < 30°. The AI, the AS as well as the LAA showed no correlation with SLAP lesions.

Level of evidence

Retrospective comparative study, Level III.

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Abbreviations

AI:

Acromion index

AUC:

Area under the curve

AS:

Acromion slope

CSA:

Critical shoulder angle

e.g.:

Exempli gratia; for example

Fig:

Figure

i.e.:

Id est; that is to say

IRB:

Institutional review board

ISP:

Infraspinatus tendon

LAA:

Lateral acromion angle

LHB:

Long head of biceps tendon

ROC:

Receiving operating characteristic

SLAP:

Superior labrum from anterior to posterior

SSC:

Subscapularis tendon

SSP:

Supraspinatus tendon

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Affiliations

  1. Orthopaedic Department, Shoulder-Elbow-Section, University of Duesseldorf, Moorenstr. 1-5, 40225, Duesseldorf, Germany

    Thilo Patzer, Nina Wimmer, Martin Hufeland, Ruediger Krauspe & Hannes Kenji Kubo

  2. Coordination Center for Clinical Trials, University of Duesseldorf, Duesseldorf, Germany

    Pablo Emilio Verde

Authors
  1. Thilo Patzer
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  2. Nina Wimmer
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  3. Pablo Emilio Verde
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  4. Martin Hufeland
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  5. Ruediger Krauspe
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  6. Hannes Kenji Kubo
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Correspondence to Thilo Patzer.

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Patzer, T., Wimmer, N., Verde, P.E. et al. The association between a low critical shoulder angle and SLAP lesions. Knee Surg Sports Traumatol Arthrosc 27, 3944–3951 (2019). https://doi.org/10.1007/s00167-019-05569-1

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  • DOI: https://doi.org/10.1007/s00167-019-05569-1

Keywords

  • Shoulder arthroscopy
  • SLAP lesion
  • Critical shoulder angle
  • Acromion index
  • Risk factor
  • Overhead sports