Does isolated arthroscopic anterior acromioplasty modify critical shoulder angle?

INTRODUCTION: Critical shoulder angle (CSA)>35° correlates significantly with primary rotator cuff tear and re-tear after repair. Acromial axial orientation varies between individuals. The present study aimed to assess the impact of strictly anterior acromioplasty on CSA. HYPOTHESIS: CSA is reduced by arthroscopic anterior acromioplasty. MATERIAL AND METHODS: A single-center retrospective study included patients receiving isolated arthroscopic acromioplasty between January 2016 and December 2017. Exclusion criteria comprised history of surgery and fracture or dislocation of the shoulder. Pre- and post-operative AP shoulder radiographs were taken. The angle subtended by a line between the inferior and superior edges of the glenoid and a line between the inferior edge of the glenoid and the most lateral point on the acromion was measured. RESULTS: One hundred and two patients were included: mean age, 50.5±10.1 years (range, 23-82 years). Mean CSA was 34.7±4.4° (range, 26-48°) preoperatively and 31.7±3.7° (range, 23-40°) postoperatively (p<0.001). In the group with CSA >35°, the decrease was significant: 34.4±3.2° (range, 28-40°) versus 38.9±2.8° (range, 36-48°) (p<0.001), with 64% CSA <35° after isolated anterior acromioplasty. DISCUSSION: CSA was decreased by arthroscopic acromioplasty. However, in 36% of cases with preoperative CSA >35°, CSA was not normalized. CONCLUSION: Anterior arthroscopic acromioplasty significantly reduced CSA in the overall population, and especially in case of high CSA. LEVEL OF EVIDENCE: IV; retrospective study.

Does anterior arthroscopic acromioplasty modify critical shoulder angle?

INTRODUCTION: Critical shoulder angle (CSA) is measured on AP view in neutral rotation as the angle subtended by the tangent to the glenoid and the lateral edge of the acromion. CSA >35° is a risk factor for primary rotator cuff tear and iterative tear after cuff repair. The aim of the present study was to assess change in CSA following arthroscopic anterior acromioplasty. HYPOTHESIS: CSA is decreased by arthroscopic anterior acromioplasty. MATERIAL AND METHOD: A single-center retrospective descriptive observational study included patients undergoing arthroscopic acromioplasty between January 2016 and December 2017, for whom strictly AP pre- and post-operative radiographs were available. Patients with history of surgery, fracture or dislocation in the same shoulder were excluded. RESULTS: 102 patients were included; mean age, 50.5 years (range, 23-82 years). Mean preoperative CSA was 34.7±4.4° (range, 26-48°) and postoperative CSA 31.7±3.7° (range, 23-40°) (p<0.001). In the pathological CSA group (>35°), the values were 38.9±2.8° (36-48°) and 34.4±3.2° (28-40°) (p<0.001), with a 64.3% rate of correction after acromioplasty. DISCUSSION: CSA decreased after arthroscopic acromioplasty. Even so, 36.7% of pathological CSAs (>35°) were not corrected, with risk of rotator cuff tear. CONCLUSION: Anterior arthroscopic acromioplasty significantly reduced CSA overall, notably in case of high CSA. LEVEL OF EVIDENCE: IV, retrospective study.

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