ShoulderRelationship of individual scapular anatomy and degenerative rotator cuff tears
Section snippets
Patient selection
On the basis of data from previously published series, pre hoc power analysis was performed for each of the outcome measures.1, 2, 3, 9, 11, 12, 18, 23 This analysis determined that for a significance level (type I error) of 5%, a sample size of 51 patients in each group was sufficient to provide a desired power of 95%.
The RCT group consisted of 51 consecutive patients who underwent arthroscopic rotator cuff surgery between January 2012 and October 2012 for a degenerative full-thickness tear
Results
The data for all parameters (median and interquartile range) are summarized in Table I.
ICCs were good to excellent for all parameters studied, with an ICCAI and ICCCSA of 0.98, ICCLAA of 0.94, ICCBigliani of 0.79, and ICCAS of 0.95.
The mean AI of the control and RCT groups was 0.66 (SD, 0.06; range, 0.53-0.79) and 0.75 (SD, 0.06; range, 0.63-0.87), respectively (P < .001). The mean LAA was 86° (SD, 7.7; range, 72°-103°) in the control group and 80° (SD, 6.3; range, 66°-93°) in the RCT group.
Discussion
The influence of individual scapular morphology on the pathogenesis of RCTs remains controversial. Although some authors place great importance on anatomic variants, particularly those of the acromion, other authors have suggested that these changes are the result of rather than the cause of degenerative rotator cuff disease.17, 19, 21, 24
Since the introduction of the AI by Nyffeler in 2006, his concept was strengthened by the contribution of several authors.2, 9, 11, 13, 18, 23, 25 In 2007,
Conclusion
This study confirms the previously reported association of the AI, LAA, and CSA with the occurrence of degenerative RCTs. Of all the assessed parameters, the CSA allowed the most accurate prediction of a patient's individual risk of experiencing a RCT.
In contrast to these findings, neither the relationship between rotator cuff disease and different types of the acromion morphology according to Bigliani and Morrison nor the association of RCTs with flattened acromial slopes could be confirmed.
Disclaimer
The authors, their immediate families, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.
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Funding: This was an internally financed study. There were no external funding sources.
IRB: This study was conducted at the Balgrist University Hospital, Zürich, according to medical-ethical guidelines after informed consent was obtained from all of the individuals studied for retrospective data analysis.