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  • Title: Critical shoulder angle and greater tuberosity angle according to the partial thickness rotator cuff tear patterns.
    Author: Seo J, Heo K, Kwon S, Yoo J.
    Journal: Orthop Traumatol Surg Res; 2019 Dec; 105(8):1543-1548. PubMed ID: 31202715.
    Abstract:
    BACKGROUND: Current studies suggest that radiographic markers such as the critical shoulder angle (CSA) and the greater tuberosity angle (GTA) are associated with rotator cuff tears (RCTs). However, because the analysis of CSAs and GTAs according to the partial thickness rotator cuff tear patterns is limited, the purpose of the present study was to evaluate the relationship of CSAs and GTAs with partial thickness rotator cuff tear (PTRCT) patterns. METHOD: This retrospective study included 1,069 patients from 2013 to 2017. The subjects were divided into 4 groups: Group A, control group; Group B, articular-sided PTRCTs; Group C, bursal-sided PTRCTs; and Group D, full thickness rotator cuff tears (FTRCTs). RCTs were diagnosed with magnetic resonance imaging and the CSA and GTA were measured on simple radiographs. Multivariable analyses were used to clarify the potential risks for these pathologies. RESULTS: The mean CSAs of articular-sided PTRCTs (34.2°±4.7°) and FTRCTs (34.7°±4.4°) were significantly larger than those of the control group (32.3°±4.3°) and the bursal-sided PTRCTs (31.5°±4.6°), (P<0.001). Multivariable analysis also showed that larger CSAs had a significantly increased risk of both articular-sided PTRCTs and FTRCTs, with odds ratios of 1.12 and 1.17 per degree, respectively. The mean GTAs of bursal-sided PTRCTs (73.2°±4.8°) and FTRCTs (72.3°±5.4°) were significantly larger than that of the control group (70.5°±5.1°) (P<0.001), although the mean GTA of articular-sided PTRCTs (71.5°±6.9°) did not show a significant difference when compared with the other groups. Multivariable analysis also showed that larger GTAs had a significantly increased risk of both bursal-sided PTRCTs and FTRCTs, with odds ratios of 1.13 and 1.07 per degree, respectively. CONCLUSION: A large critical shoulder angle was associated more with articular-sided PTRCTs than bursal-sided PTRCTs. A large greater tuberosity angle was associated more with bursal-sided PTRCTs than with articular-sided PTRCTs. Both critical shoulder angle and greater tuberosity angle were positively associated with the occurrence of full thickness rotator cuff tears. LEVEL OF EVIDENCE: IV, Retrospective study.
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