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Does anterior acromioplasty reduce critical shoulder angle?
Mathieu Girard1, Romain Colombi2, Vadim Azoulay1
1Centre hospitalier universitaire de Toulouse, hôpital Pierre-Paul Riquet, place Baylac, 31059 Toulouse cedex 09, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|July 25, 2020
Summary
Anterior acromioplasty significantly reduces the critical shoulder angle (CSA), a risk factor for rotator cuff tears. However, the reduction may not always normalize the angle below the threshold for iterative tears.
Area of Science:
- Orthopedic Surgery
- Shoulder Biomechanics
- Radiographic Analysis
Background:
- The critical shoulder angle (CSA) is defined by glenoid inclination and the lateral acromion edge.
- A CSA exceeding 35° is a recognized risk factor for rotator cuff tendon tears.
- Anterior acromioplasty is a surgical procedure aimed at addressing shoulder pathologies.
Purpose of the Study:
- To evaluate the change in CSA following anterior acromioplasty.
- To test the hypothesis that anterior acromioplasty significantly reduces CSA.
Main Methods:
- A retrospective descriptive observational study.
- Inclusion of 148 patients who underwent open or arthroscopic anterior acromioplasty.
- Analysis of pre- and post-operative anteroposterior radiographs meeting Moor's criteria.
Main Results:
- Mean preoperative CSA was 36.1°, reduced to 33.5° postoperatively (p=0.001).
- The mean reduction in CSA was -2.6°, irrespective of surgical technique (open vs. arthroscopic).
- In cases with pathologic CSA (>35°), 48% normalized below the 35° threshold post-surgery.
Conclusions:
- Anterior acromioplasty leads to a significant reduction in CSA.
- The achieved reduction may not consistently normalize CSA below the 35° threshold for iterative tears.
- Predicting intraoperative CSA changes remains challenging, potentially requiring further resection techniques.
