A high acromion-greater tuberosity impingement index increases the risk of retear after arthroscopic rotator cuff repair

J Orthop Surg (Hong Kong). 2022 Jan-Apr;30(1):10225536221092219. doi: 10.1177/10225536221092219.

Abstract

Background: No evaluation has been done on the relationship of the acromion-greater tuberosity impingement index (ATI) with retear after arthroscopic rotator cuff repair (ARCR). Our purpose was to evaluate whether a higher ATI is associated with retear after ARCR.

Methods: 132 patients received ARCR and underwent MRI scan at a one year follow-up to assess tendon healing, and the findings were graded no retear (NR), partial-thickness retear (PR) or full-thickness retear (FR). The ATI, the critical shoulder angle (CSA), acromion index (AI) and lateral acromial angle (LAA) were measured with postoperative radiographs. Functional scores were obtained preoperatively and at a one year follow-up.

Results: Postoperative Constant scores and ASES scores were significantly different between groups with inferior outcomes in the FR group (p < 0.05 for all). The UCLA score was significantly better in the NR group compared with the PR and FR groups (p < 0.05), and in the PR group compared with the FR group (p < 0.05). For ATI and CSA, the values of the PR and FR groups were larger than the NR group (p < 0.05 for all), but there were no significant differences between the PR and FR groups (p > 0.05 for all). No significant differences were observed with regard to the AI and LAA (p > 0.05, respectively). The repair integrity was positively related to the ATI (0.304, p < 0.05) and CSA (0.252, p < 0.05), but not related to the AI or LAA (p > 0.05 for both). ATI was not related to any functional scores (p > 0.05 for all).

Conclusion: This study revealed that the ATI was positively related to rotator cuff retear. Patients with retears had significantly greater ATIs after ARCR. Level of Evidence: III, case-control study.

Keywords: acromion–greater tuberosity impingement index; critical shoulder angle; retear; rotator cuff repair; rotator cuff tear.

MeSH terms

  • Acromion* / diagnostic imaging
  • Acromion* / surgery
  • Arthroscopy / adverse effects
  • Case-Control Studies
  • Humans
  • Magnetic Resonance Imaging
  • Recurrence
  • Rotator Cuff / diagnostic imaging
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries* / diagnostic imaging
  • Rotator Cuff Injuries* / surgery
  • Treatment Outcome