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Association of a Large Lateral Extension of the Acromion with Rotator Cuff Tears

¹ Department of Orthopaedic Surgery, University of Bern, Inselspital, 3010 Bern, Switzerland. E-mail address: richard.nyffeler{at}bluewin.ch
² Departments of Orthopaedic Surgery (C.M.L.W., A.S., and C.G.) and Radiology (M.R.S.), University of Zurich, Balgrist, Forchstrasse 340, 8008 Zurich, Switzerland

Investigation performed at the Department of Orthopaedic Surgery, University of Zurich, Balgrist, Switzerland

In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from ResOrtho Foundation, Zurich, Switzerland. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Methods: The lateral extension of the acromion was assessed on true anteroposterior radiographs made with the arm in neutral rotation. The distance from the glenoid plane to the lateral border of the acromion was divided by the distance from the glenoid plane to the lateral aspect of the humeral head to calculate the acromion index. This index was determined in a group of 102 patients (average age, 65.0 years) with a proven full-thickness rotator cuff tear, in an age and gender-matched group of forty-seven patients (average age, 63.7 years) with osteoarthritis of the shoulder and an intact rotator cuff, and in an age and gender-matched control group of seventy volunteers (average age, 64.4 years) with an intact rotator cuff as demonstrated by ultrasonography.

Results: The average acromion index (and standard deviation) was 0.73 ± 0.06 in the shoulders with a full-thickness tear, 0.60 ± 0.08 in those with osteoarthritis and an intact rotator cuff, and 0.64 ± 0.06 in the asymptomatic, normal shoulders with an intact rotator cuff. The difference between the index in the shoulders with a full-thickness supraspinatus tear and the index in those with an intact rotator cuff was highly significant (p < 0.0001).

Conclusions: A large lateral extension of the acromion appears to be associated with full-thickness tearing of the rotator cuff.

Level of Evidence: Diagnostic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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