Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2012

01-02-2012 | Shoulder

Do anatomic variants of the acromion shape in the frontal plane influence pain and function in calcifying tendinitis of the shoulder?

Authors: Jörn Kircher, Markus Morhard, Thilo Patzer, Petra Magosch, Sven Lichtenberg, Peter Habermeyer

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2012

Login to get access

Abstract

Purpose

To evaluate the relationship of a large acromion index and calcifying tendinitis of the supraspinatus tendon at the shoulder.

Materials and methods

Between 2002 and 2008, 109 consecutive patients with isolated calcifying tendinitis of the supraspinatus tendon were prospectively analysed by clinical investigation and standardized radiographs. Deposit size and appearance were measured and classified according to Bosworth and Gartner. The acromion index (AI) was calculated based on measurements on true anteroposterior radiographs. Pain record on VAS scale, active and passive range of motion and the constant score (CS) were recorded.

Results

The mean age of the patients was 48.2 ± 8.0 (n = 46 male 48.6 ± 7.3; n = 63 female 47.9 ± 8.6; P > 0.05). Pain and function were not significantly correlated with deposit size or classification. The acromion index (mean 0.64 ± 0.08) was not significantly correlated with the affected or dominant side, gender, deposit size or classification or any functional parameter like pain and the CS or its subgroups.

Conclusion

The theoretical concept of a high acromion index resulting in an increased resulting upward force against the subacromial space, which influences pain and function in calcifying tendinitis of the shoulder, was not supported.

Level of evidence

Diagnostic clinical study, Level II.
Literature
1.
go back to reference Archer RS, Bayley JI, Archer CW, Ali SY (1993) Cell and matrix changes associated with pathological calcification of the human rotator cuff tendons. J Anat 182(Pt 1):1–11PubMed Archer RS, Bayley JI, Archer CW, Ali SY (1993) Cell and matrix changes associated with pathological calcification of the human rotator cuff tendons. J Anat 182(Pt 1):1–11PubMed
2.
go back to reference Bosworth B (1941) Calcium deposits in the shoulder and subacromial bursitis: a survey of 12.122 shoulders. JAMA 116:2477–2482CrossRef Bosworth B (1941) Calcium deposits in the shoulder and subacromial bursitis: a survey of 12.122 shoulders. JAMA 116:2477–2482CrossRef
3.
go back to reference Depalma AF, Kruper JS (1961) Long-term study of shoulder joints afflicted with and treated for calcific tendinitis. Clin Orthop Relat Res 20:61–72 Depalma AF, Kruper JS (1961) Long-term study of shoulder joints afflicted with and treated for calcific tendinitis. Clin Orthop Relat Res 20:61–72
4.
go back to reference Gartner J, Heyer A (1995) Calcific tendinitis of the shoulder. Orthopade 24(3):284–302PubMed Gartner J, Heyer A (1995) Calcific tendinitis of the shoulder. Orthopade 24(3):284–302PubMed
5.
go back to reference Gartner J, Simons B (1990) Analysis of calcific deposits in calcifying tendinitis. Clin Orthop Relat Res 254:111–120PubMed Gartner J, Simons B (1990) Analysis of calcific deposits in calcifying tendinitis. Clin Orthop Relat Res 254:111–120PubMed
6.
go back to reference Gotoh M, Higuchi F, Suzuki R, Yamanaka K (2003) Progression from calcifying tendinitis to rotator cuff tear. Skeletal Radiol 32(2):86–89PubMedCrossRef Gotoh M, Higuchi F, Suzuki R, Yamanaka K (2003) Progression from calcifying tendinitis to rotator cuff tear. Skeletal Radiol 32(2):86–89PubMedCrossRef
7.
go back to reference Hamada J, Ono W, Tamai K, Saotome K, Hoshino T (2001) Analysis of calcium deposits in calcific periarthritis. J Rheumatol 28(4):809–813PubMed Hamada J, Ono W, Tamai K, Saotome K, Hoshino T (2001) Analysis of calcium deposits in calcific periarthritis. J Rheumatol 28(4):809–813PubMed
8.
go back to reference Harvie P, Pollard TC, Carr AJ (2007) Calcific tendinitis: natural history and association with endocrine disorders. J Shoulder Elbow Surg 16(2):169–173PubMedCrossRef Harvie P, Pollard TC, Carr AJ (2007) Calcific tendinitis: natural history and association with endocrine disorders. J Shoulder Elbow Surg 16(2):169–173PubMedCrossRef
9.
go back to reference Hedtmann A, Fett H (1989) So-called humero-scapular periarthropathy–classification and analysis based on 1, 266 cases. Z Orthop Ihre Grenzgeb 127(6):643–649PubMedCrossRef Hedtmann A, Fett H (1989) So-called humero-scapular periarthropathy–classification and analysis based on 1, 266 cases. Z Orthop Ihre Grenzgeb 127(6):643–649PubMedCrossRef
10.
go back to reference Kappe T, Cakir B, Lippacher S, Reichel H, Elsharkawi M (2011) Intraarticular lesions in calcifying tendinitis: incidence and association with the acromion index. Arch Orthop Trauma Surg 131(3):325–329PubMedCrossRef Kappe T, Cakir B, Lippacher S, Reichel H, Elsharkawi M (2011) Intraarticular lesions in calcifying tendinitis: incidence and association with the acromion index. Arch Orthop Trauma Surg 131(3):325–329PubMedCrossRef
11.
go back to reference Kircher J, Morhard M, Gavriilidis I, Magosch P, Lichtenberg S, Habermeyer P (2010) Is there an association between a low acromion index and osteoarthritis of the shoulder? Int Orthop 34(5):1005–1010PubMedCrossRef Kircher J, Morhard M, Gavriilidis I, Magosch P, Lichtenberg S, Habermeyer P (2010) Is there an association between a low acromion index and osteoarthritis of the shoulder? Int Orthop 34(5):1005–1010PubMedCrossRef
12.
go back to reference Kircher J, Morhard M, Magosch P, Ebinger N, Lichtenberg S, Habermeyer P (2010) How much are radiological parameters related to clinical symptoms and function in osteoarthritis of the shoulder? Int Orthop 34(5):677–681PubMedCrossRef Kircher J, Morhard M, Magosch P, Ebinger N, Lichtenberg S, Habermeyer P (2010) How much are radiological parameters related to clinical symptoms and function in osteoarthritis of the shoulder? Int Orthop 34(5):677–681PubMedCrossRef
13.
go back to reference Loew M, Sabo D, Wehrle M, Mau H (1996) Relationship between calcifying tendinitis and subacromial impingement: a prospective radiography and magnetic resonance imaging study. J Shoulder Elbow Surg 5(4):314–319PubMedCrossRef Loew M, Sabo D, Wehrle M, Mau H (1996) Relationship between calcifying tendinitis and subacromial impingement: a prospective radiography and magnetic resonance imaging study. J Shoulder Elbow Surg 5(4):314–319PubMedCrossRef
14.
go back to reference Maier M, Maier-Bosse T, Eckermann M, Maier-Bosse E, Schulz CU, Steinborn M, Kleen M, Stabler A (2003) The roentgenmorphologic aspects of symptomatic calcifications in patients with calcifying tendinitis of the shoulder: determination of intra- and interobserver variabilities of Gartner’s classification. Unfallchirurg 106(3):185–189PubMedCrossRef Maier M, Maier-Bosse T, Eckermann M, Maier-Bosse E, Schulz CU, Steinborn M, Kleen M, Stabler A (2003) The roentgenmorphologic aspects of symptomatic calcifications in patients with calcifying tendinitis of the shoulder: determination of intra- and interobserver variabilities of Gartner’s classification. Unfallchirurg 106(3):185–189PubMedCrossRef
15.
go back to reference Maier M, Maier-Bosse T, Veihelmann A, Pellengahr C, Steinborn M, Kleen M, Schulz CU (2003) Observer variabilities of radiological classifications of calcified deposits in calcifying tendinitis of the shoulder. Acta Orthop Belg 69(3):222–225PubMed Maier M, Maier-Bosse T, Veihelmann A, Pellengahr C, Steinborn M, Kleen M, Schulz CU (2003) Observer variabilities of radiological classifications of calcified deposits in calcifying tendinitis of the shoulder. Acta Orthop Belg 69(3):222–225PubMed
16.
go back to reference Maier M, Stabler A, Lienemann A, Kohler S, Feitenhansl A, Durr HR, Pfahler M, Refior HJ (2000) Shockwave application in calcifying tendinitis of the shoulder–prediction of outcome by imaging. Arch Orthop Trauma Surg 120(9):493–498PubMedCrossRef Maier M, Stabler A, Lienemann A, Kohler S, Feitenhansl A, Durr HR, Pfahler M, Refior HJ (2000) Shockwave application in calcifying tendinitis of the shoulder–prediction of outcome by imaging. Arch Orthop Trauma Surg 120(9):493–498PubMedCrossRef
17.
go back to reference Maier M, Tischer T, Anetzberger H, Gerdesmeyer L, Pellengahr C, Schulz CU, Schmitz C, Michalke B (2002) Mineral analysis of roentgenologically defined calcifications in patients with chronic calcifying tendinitis of the rotator cuff. Z Orthop Ihre Grenzgeb 140(4):399–403PubMedCrossRef Maier M, Tischer T, Anetzberger H, Gerdesmeyer L, Pellengahr C, Schulz CU, Schmitz C, Michalke B (2002) Mineral analysis of roentgenologically defined calcifications in patients with chronic calcifying tendinitis of the rotator cuff. Z Orthop Ihre Grenzgeb 140(4):399–403PubMedCrossRef
18.
go back to reference Mc Laughlin HL, Asherman EG (1951) Lesions of the musculotendinous cuff of the shoulder. IV. Some observations based upon the results of surgical repair. J Bone Joint Surg Am 33(A:1):76–86 Mc Laughlin HL, Asherman EG (1951) Lesions of the musculotendinous cuff of the shoulder. IV. Some observations based upon the results of surgical repair. J Bone Joint Surg Am 33(A:1):76–86
19.
go back to reference Mole D, Kempf JF, Gleyze P, Rio B, Bonnomet F, Walch G (1993) Results of endoscopic treatment of non-broken tendinopathies of the rotator cuff.2. Calcifications of the rotator cuff. Rev Chir Orthop Reparatrice Appar Mot 79(7):532–541PubMed Mole D, Kempf JF, Gleyze P, Rio B, Bonnomet F, Walch G (1993) Results of endoscopic treatment of non-broken tendinopathies of the rotator cuff.2. Calcifications of the rotator cuff. Rev Chir Orthop Reparatrice Appar Mot 79(7):532–541PubMed
20.
go back to reference Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C (2006) Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am 88(4):800–805PubMedCrossRef Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C (2006) Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am 88(4):800–805PubMedCrossRef
21.
go back to reference Riley GP, Harrall RL, Constant CR, Cawston TE, Hazleman BL (1996) Prevalence and possible pathological significance of calcium phosphate salt accumulation in tendon matrix degeneration. Ann Rheum Dis 55(2):109–115PubMedCrossRef Riley GP, Harrall RL, Constant CR, Cawston TE, Hazleman BL (1996) Prevalence and possible pathological significance of calcium phosphate salt accumulation in tendon matrix degeneration. Ann Rheum Dis 55(2):109–115PubMedCrossRef
22.
go back to reference Rompe JD, Zollner J, Nafe B, Freitag C (2000) Significance of calcium deposit elimination in tendinosis calcarea of the shoulder. Z Orthop Ihre Grenzgeb 138(4):335–339PubMedCrossRef Rompe JD, Zollner J, Nafe B, Freitag C (2000) Significance of calcium deposit elimination in tendinosis calcarea of the shoulder. Z Orthop Ihre Grenzgeb 138(4):335–339PubMedCrossRef
23.
go back to reference Rupp S, Seil R, Kohn D (1998) Preoperative ultrasonographic mapping of calcium deposits facilitates localization during arthroscopic surgery for calcifying tendinitis of the rotator cuff. Arthroscopy 14(5):540–542PubMedCrossRef Rupp S, Seil R, Kohn D (1998) Preoperative ultrasonographic mapping of calcium deposits facilitates localization during arthroscopic surgery for calcifying tendinitis of the rotator cuff. Arthroscopy 14(5):540–542PubMedCrossRef
24.
go back to reference Rupp S, Seil R, Kohn D (2000) Tendinosis calcarea of the rotator cuff. Orthopade 29(10):852–867CrossRef Rupp S, Seil R, Kohn D (2000) Tendinosis calcarea of the rotator cuff. Orthopade 29(10):852–867CrossRef
25.
go back to reference Takeuchi E, Sugamoto K, Nakase T, Miyamoto T, Kaneko M, Tomita T, Myoui A, Ochi T, Yoshikawa H (2001) Localization and expression of osteopontin in the rotator cuff tendons in patients with calcifying tendinitis. Virchows Arch 438(6):612–617PubMedCrossRef Takeuchi E, Sugamoto K, Nakase T, Miyamoto T, Kaneko M, Tomita T, Myoui A, Ochi T, Yoshikawa H (2001) Localization and expression of osteopontin in the rotator cuff tendons in patients with calcifying tendinitis. Virchows Arch 438(6):612–617PubMedCrossRef
26.
go back to reference Tillander BM, Norlin RO (1998) Change of calcifications after arthroscopic subacromial decompression. J Shoulder Elbow Surg 7(3):213–217PubMedCrossRef Tillander BM, Norlin RO (1998) Change of calcifications after arthroscopic subacromial decompression. J Shoulder Elbow Surg 7(3):213–217PubMedCrossRef
27.
go back to reference Uhthoff HK (1975) Calcifying tendinitis, an active cell-mediated calcification. Virchows Arch A Pathol Anat Histol 366(1):51–58PubMedCrossRef Uhthoff HK (1975) Calcifying tendinitis, an active cell-mediated calcification. Virchows Arch A Pathol Anat Histol 366(1):51–58PubMedCrossRef
28.
go back to reference Uhthoff HK, Loehr JW (1997) calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis, and management. J Am Acad Orthop Surg 5(4):183–191PubMed Uhthoff HK, Loehr JW (1997) calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis, and management. J Am Acad Orthop Surg 5(4):183–191PubMed
29.
go back to reference Uhthoff HK, Sarkar K, Maynard JA (1976) Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res 118:164–168PubMed Uhthoff HK, Sarkar K, Maynard JA (1976) Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res 118:164–168PubMed
30.
go back to reference Zumstein MA, Jost B, Hempel J, Hodler J, Gerber C (2008) The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg Am 90(11):2423–2431PubMedCrossRef Zumstein MA, Jost B, Hempel J, Hodler J, Gerber C (2008) The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg Am 90(11):2423–2431PubMedCrossRef
Metadata
Title
Do anatomic variants of the acromion shape in the frontal plane influence pain and function in calcifying tendinitis of the shoulder?
Authors
Jörn Kircher
Markus Morhard
Thilo Patzer
Petra Magosch
Sven Lichtenberg
Peter Habermeyer
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1563-4

Other articles of this Issue 2/2012

Knee Surgery, Sports Traumatology, Arthroscopy 2/2012 Go to the issue