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International Orthopaedics

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01-11-2013 | Original Paper

The acromial index is not predictive for failed rotator cuff repair

Authors: Patricio Melean, Sven Lichtenberg, Fredy Montoya, Stephan Riedmann, Petra Magosch, Peter Habermeyer

Published in: International Orthopaedics | Issue 11/2013

Abstract

Background

The main objective of this study was to evaluate the association between the acromial index (AI) and the incidence of recurrent tears of the rotator cuff (RC) in a cohort of patients with full thickness tears who underwent arthroscopic primary repair.

Methods

A prognostic study of a prospective case series of 103 patients with full thickness RC tears was undertaken. The average age was 59.5 years (39–74) and follow-up was 30.81 months (12–72). True anterior–posterior X-rays were obtained during the pre-operative evaluation. Pre and post-operative magnetic resonance imaging (MRI) were recorded.

Results

Eighteen cases with recurrent tears (17.4 %) were seen on post-operative MRI. The average AI for patients with recurrent tears was 0.711 ± 0.065 and for patients without recurrent tears 0.710 ± 0.064 (p < 0.05). A positive association between age and recurrent tears of the RC was noted (average ages: recurrent tears group 63 ± 5.9 years; group without recurrent tears 58.8 ± 7.5 years) (r = −0.216; p = 0.029). We did not find an association between size of the primary tear and recurrent tears (r = −0.075; p < 0.05) or between degrees of retraction of the primary and recurrent tears of the cuff (r = −0.073; p < 0.05). We observed that 38.9 % of the recurrent tears cases presented with more than one tendon affected before the arthroscopy. At follow-up, none of these recurrent tears showed more than one tendon affected on MRI evaluation.

Conclusion

In this study, we found that the AI radiological measurement is not a predictor for recurrent tears of the RC after primary arthroscopic repair.

Pfalzer F, Endele D, Huth J, Bauer G, Mauch F (2011) Clinical and MRI results after arthroscopic rotator cuff repair using the double-row technique. A consecutive study. [Klinische und magnetresonanztomographische Ergebnisse nach arthroskopischer Rotatorenmanschettenrekonstruktion in “Double-row”-Technik. Eine serielle Studie]. Obere Extremitat 6(4):267–274. doi:10.1007/s11678-011-0117-1 CrossRef

Papadopoulos P, Karataglis D, Boutsiadis A, Fotiadou A, Christoforidis J, Christodoulou A (2011) Functional outcome and structural integrity following mini-open repair of large and massive rotator cuff tears: a 3-5 year follow-up study. J Shoulder Elbow Surg 20(1):131–137. doi:10.1016/j.jse.2010.05.026 PubMedCrossRef

Hanusch BC, Goodchild L, Finn P, Rangan A (2009) Large and massive tears of the rotator cuff: functional outcome and integrity of the repair after a mini-open procedure. J Bone Joint Surg Am B 91(2):201–205. doi:10.1302/0301-620X.91B2.21286 CrossRef

Cummins CA, Murrell GAC (2003) Mode of failure for rotator cuff repair with suture anchors identified at revision surgery. J Shoulder Elbow Surg 12(2):128–133. doi:10.1067/mse.2003.21 PubMedCrossRef

Miller BS, Downie BK, Kohen RB, Kijek T, Lesniak B, Jacobson JA, Hughes RE, Carpenter JE (2011) When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am J Sports Med 39(10):2064–2070. doi:10.1177/0363546511413372 PubMedCrossRef

Cho NS, Lee BG, Rhee YG (2011) Arthroscopic rotator cuff repair using a suture bridge technique: is the repair integrity actually maintained? Am J Sports Med 39(10):2108–2116. doi:10.1177/0363546510397171 PubMedCrossRef

Kluger R, Bock P, Mittlböck M, Krampla W, Engel A (2011) Long-term survivorship of rotator cuff repairs using ultrasound and magnetic resonance imaging analysis. Am J Sports Med 39(10):2071–2081. doi:10.1177/0363546511406395 PubMedCrossRef

Denard PJ, Burkhart SS (2011) Techniques for managing poor quality tissue and bone during arthroscopic rotator cuff repair. Arthroscopy 27(10):1409–1421. doi:10.1016/j.arthro.2011.05.015 PubMedCrossRef

Laron D, Samagh SP, Liu X, Kim HT, Feeley BT (2012) Muscle degeneration in rotator cuff tears. J Shoulder Elbow Surg 21(2):164–174. doi:10.1016/j.jse.2011.09.027 PubMedCrossRef

10.

Kang JR, Gupta R (2012) Mechanisms of fatty degeneration in massive rotator cuff tears. J Shoulder Elbow Surg 21(2):175–180. doi:10.1016/j.jse.2011.11.017 PubMedCrossRef

11.

Kolbe AB, Collins MS, Sperling JW (2012) Severe atrophy and fatty degeneration of the infraspinatus muscle due to isolated infraspinatus tendon tear. Skeletal Radiol 41(1):107–110. doi:10.1007/s00256-011-1265-5 PubMedCrossRef

12.

Harrison AK, Flatow EL (2011) Subacromial impingement syndrome. J Am Acad Orthop Surg 19(11):701–708PubMed

13.

Papadonikolakis A, McKenna M, Warme W, Martin BI, Matsen FA III (2011) Published evidence relevant to the diagnosis of impingement syndrome of the shoulder. J Bone Joint Surg Am A 93(19):1827–1832. doi:10.2106/JBJS.I.01286 CrossRef

14.

Garofalo R, Karlsson J, Nordenson U, Cesari E, Conti M, Castagna A (2010) Anterior-superior internal impingement of the shoulder: an evidence-based review. Knee Surg Sports Traumatol Arthrosc 18(12):1688–1693. doi:10.1007/s00167-010-1232-z PubMedCrossRef

15.

Kim JR, Ryu KJ, Hong IT, Kim BK, Kim JH (2012) Can a high acromion index predict rotator cuff tears? Int Orthop 36(5):1019–1024. doi:10.1007/s00264-012-1499-4 PubMedCrossRef

16.

Miyazaki AN, Itoi E, Sano H, Fregoneze M, Santos PD, da Silva LA, Sella Gdo V, Martel EM, Debom LG, Andrade ML, Checchia SL (2011) Comparison between the acromion index and rotator cuff tears in the Brazilian and Japanese populations. J Shoulder Elbow Surg 20(7):1082–1086. doi:10.1016/j.jse.2011.04.028 PubMedCrossRef

17.

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):800–805. doi:10.2106/JBJS.D.03042 PubMedCrossRef

18.

Torrens C, López JM, Puente I, Cáceres E (2007) The influence of the acromial coverage index in rotator cuff tears. J Shoulder Elbow Surg 16(3):347–351. doi:10.1016/j.jse.2006.07.006 PubMedCrossRef

19.

Sukthankar A, Werner CM, Brucker P, Nyffeler RW, Gerber C (2009) Lateral extension of the acromion and rotator cuff tears—a prospective study. J Bone Joint Surg Br 91-B(Supp I):123

20.

Lichtenberg S, Liem D, Magosch P, Habermeyer P (2006) Influence of tendon healing after arthroscopic rotator cuff repair on clinical outcome using single-row Mason-Allen suture technique: a prospective, MRI controlled study. Knee Surg Sports Traumatol Arthrosc 14(11):1200–1206. doi:10.1007/s00167-006-0132-8 PubMedCrossRef

21.

Thomazeau H, Rolland Y, Lucas C, Duval JM, Langlais F (1996) Atrophy of the supraspinatus belly: assessment by MRI in 55 patients with rotator cuff pathology. Acta Orthop Scand 67:264–268PubMedCrossRef

22.

Lichtenberg S, Habermeyer P, Magosch P (2008) Atlas Schulterarthroskopie. Urban & Fischer by Elsevier, first edition. Arthroskopische Chirugie des Subakromialraums, pp 124–126

23.

Patte D (1990) Classification of rotator cuff lesions. Clin Orthop 254:81–86PubMed

24.

Codman EA, Akerson IB (1931) The pathology associated with rupture of the supraspinatus tendon. Ann Surg 93(1):348–359PubMedCrossRef

25.

Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S (1988) Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am 70(8):1224–1230PubMed

26.

MacDonald P, McRae S, Leiter J, Mascarenhas R, Lapner P (2011) Arthroscopic rotator cuff repair with and without acromioplasty in the treatment of full-thickness rotator cuff tears: a multicenter, randomized controlled trial. J Bone Joint Surg Am 93(21):1953–1960. doi:10.2106/JBJS.K.00488 PubMedCrossRef

27.

Papadonikolakis A, McKenna M, Warme W, Martin BI, Matsen FA 3rd (2011) Published evidence relevant to the diagnosis of impingement syndrome of the shoulder. J Bone Joint Surg Am 93(19):1827–1832. doi:10.2106/JBJS.J.01748 PubMedCrossRef

28.

Armstrong JR (1949) Excision of the acromion in treatment of the supraspinatus syndrome; report of 95 excisions. J Bone Joint Surg Br 31B(3):436–442PubMed

29.

Neer CS 2nd (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54:41–50PubMed

30.

Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC (1991) The relationship of acromial architecture to rotator cuff disease. Clin Sports Med 10:823–838PubMed

31.

MacGillivray JD, Fealy S, Potter HG, O‘Brien SJ (1998) Multiplanar analysis of acromion morphology. Am J Sports Med 26(6):836–840PubMed

32.

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):2423–2431. doi:10.2106/JBJS.G.00677 PubMedCrossRef

33.

Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 87(6):1229–1240. doi:10.2106/JBJS.D.02035 PubMedCrossRef

Title: The acromial index is not predictive for failed rotator cuff repair
Authors: Patricio Melean
Sven Lichtenberg
Fredy Montoya
Stephan Riedmann
Petra Magosch
Peter Habermeyer
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 11/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-1963-9

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Springer Medicine

The acromial index is not predictive for failed rotator cuff repair

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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