title: Three-dimensional analysis of acromial morphologic characteristics in patients with and without rotator cuff tears using a reconstructed computed tomography model.
abstract: BACKGROUND
  The relationship between rotator cuff tears and acromial shape has yet to be clarified. As a result, the most suitable location for acromioplasty for the treatment of rotator cuff tears is not known.
  
  
  OBJECTIVE
  To determine whether any particular change in acromial shape is significantly associated with the presence of rotator cuff tears.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  From 2007 to 2010, we examined 25 consecutive patients with unilateral full-thickness rotator cuff tears who underwent arthroscopic repair and 17 consecutive patients with adhesive capsulitis but intact rotator cuffs who underwent arthroscopic capsular release. Before surgery, a reconstructed 3-dimensional computed tomography model was used to evaluate the acromial structure. Changes in the shape of the affected scapula were qualitatively evaluated relative to the unaffected, contralateral scapula by use of proximity mapping. Differences in acromial structure between affected and unaffected shoulders were assessed at the anterior, lateral, and medial edges and the inferior surface. The association between rotator cuff tear size and change in acromial structure was also evaluated.
  
  
  RESULTS
  Rates of bony projection at the anterior (>2 mm) and lateral (>3 mm) edges of the acromion in patients with rotator cuff tears were significantly greater compared with rates in patients without rotator cuff tears (P < .01). Tear size was not correlated with changes in acromial structure (P = .37-.73).
  
  
  CONCLUSIONS
  Bone spurs at the anterior and lateral edges of the acromion are associated with the presence of full-thickness rotator cuff tears in symptomatic patients.
authors.affiliation: Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Japan.
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Fujisawa
authors.affiliation: Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Japan tmihata@yahoo.co.jp tmihata@poh.osaka-med.ac.jp.
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Mihata
authors.affiliation: Department of Orthopedic Biomaterial Science, Osaka University, Suita, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Murase
authors.affiliation: Department of Orthopedic Biomaterial Science, Osaka University, Suita, Japan.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Sugamoto
authors.affiliation: Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Neo
mesh_terms: D000174:Acromion / Q000033:anatomy & histology*; D000328:Adult; D000368:Aged; D002062:Bursitis / Q000000981:diagnostic imaging* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D057913:Joint Capsule Release; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000000981:diagnostic imaging; D012372:ROC Curve; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: acromion; morphology; rotator cuff; shoulder; spur; tear