Does scapular morphology affect the integrity of the rotator cuff?

Area of Science:

• Orthopedic Surgery
• Radiology
• Sports Medicine

Background:

• Distinct scapular morphologies may predispose individuals to rotator cuff tears.
• Radiographic acromial characteristics are increasingly recognized as potential risk factors for rotator cuff pathology.

Purpose of the Study:

• To evaluate the relationship between symptomatic degenerative rotator cuff tears and radiographic acromial characteristics.
• To determine if acromion shape, acromial index (AI), critical shoulder angle (CSA), or acromial spur are predictive of rotator cuff tears.

Main Methods:

• A longitudinal study involving 166 patients divided into three matched groups: full-thickness tear, partial-thickness tear, and normal cuff.
• Evaluation using standard radiographs and ultrasonography.
• Statistical analysis including logistic regression and receiver operating characteristic (ROC) curve analysis.

Main Results:

• Acromial spurs were strongly associated with full-thickness rotator cuff tears (odds ratio, 3.5; P = .001).
• Higher acromial index (AI) and critical shoulder angle (CSA) showed statistically significant differences in full-thickness tear group compared to normal cuff group.
• Critical shoulder angle (CSA) demonstrated a higher predictive value (area under ROC curve = 0.70) than acromial index (AI = 0.61) for full-thickness tears. Acromial spur and CSA were confirmed as stronger predictors.

Conclusions:

• Acromial spurs are a significant predictor of full-thickness rotator cuff tears.
• Elevated AI and CSA are associated with full-thickness tears, but not partial tears.
• Acromial morphology type (e.g., Bigliani type) was not found to be related to rotator cuff tear presence.