Thursday, November 8, 2018

Critical shoulder angle and cuff tears - are the differences clinically significant?

Critical shoulder angle in an East Asian population: correlation to the incidence of rotator cuff tear and glenohumeral osteoarthritis

These authors examined the correlation between the critical shoulder angle (CSA) measured on anteroposterior radiographs 

and the presence or absence of rotator cuff tears or OA changes was assessed in 295 patients. Rotator cuff tears were diagnosed with magnetic resonance imaging or ultrasonography.

The mean CSA with rotator cuff tear (33.9° ± 4.1°) was significantly greater than that without a rotator cuff tear (32.3° ± 4.5°; P = .002). Multivariable analysis also showed that a greater CSA had a significantly increased risk of rotator cuff tears, with the odds ratio of 1.08 per degree. 

In contrast to prior studies, osteoarthritis showed no significant correlation to the CSA.

Comment: These authors suggest that the CSA "may be an independent risk factor for the incidence of rotator cuff tears in the Japanese population. "

While the difference in CSA between patients with and without cuff tears appears statistically significant, one must wonder whether a difference of 1.6° can contribute to the risk of rotator cuff tear. Might instead the difference in CSA be a result rather than the cause of cuff tears (see this link)?

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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You may be interested in some of our most visited web pages arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'