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Web End = Knee Surg Sports Traumatol Arthrosc (2016) 24:22002205 DOI 10.1007/s00167-014-3499-y
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Web End = SHOULDER
Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears
Maurice Balke Dennis Liem Oliver Greshake Juergen Hoeher Bertil Bouillon Marc Banerjee
Received: 11 July 2014 / Accepted: 22 December 2014 / Published online: 30 December 2014 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2014
between degenerative and traumatic tears. Slope: 21.2 (SD 7.6) versus 19.2 (SD 7.9, p = 0.026), AH dis
tance: 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 signicantly older (60 vs. 54 years).
Conclusions The hypothesis that the acromial morphology of patients with degenerative supraspinatus tendon tears differs from patients with traumatic tears was conrmed. 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 IV.
Keywords Shoulder trauma Rotator cuff tear Acromial morphology Subacromial decompression Bigliani
Introduction
Rotator cuff (RC) tears are very common disorders leading to surgical treatment. With increasing age, the incidence of these tears also increases signicantly [25]. The aetiology of RC tears is multifactorial. The factors leading to injuries of the tendons can be categorized in intrinsic, extrinsic, and traumatic causes [411, 13, 15, 18, 23, 25, 26, 28, 29, 31, 33, 37, 39]. Intrinsic degeneration of the tendon is mainly associated with age of the patient, decreased vascularization
Abstract
Purpose Distinct characteristics of acromial morphology seem to be one factor for the development of degenerative supraspinatus tendon tears. Thus, it is questionable...