Grade of coracoacromial ligament degeneration as a predictive factor for impingement syndrome and type of partial rotator cuff tear.
BACKGROUND
The purpose of this study was to investigate the role of coracoacromial ligament degeneration and specific anatomic parameters in the etiology of partial-thickness rotator cuff tears.


METHODS
This study retrospectively assessed 96 patients (mean age, 50.1 years [17-76]; 34 men, 62 women) diagnosed with bursal-side and articular-side rotator cuff tears with a history of failed conservative treatment and persistent shoulder pain who underwent arthroscopic surgery. Video records of the surgery were used to evaluate the type of cuff tear, grade of coracoacromial ligament degeneration, and associated pathologic changes; preoperative magnetic resonance images were used to measure acromioglenoid angle, supraspinatus glenoid angle, and subacromial distance.


RESULTS
Most of the patients with articular-side tears demonstrated grade 0 and grade 1 coracoacromial ligament degeneration, whereas patients with bursal-side tears had grade 1 and grade 2. There was a significant positive correlation between the grade of coracoacromial ligament degeneration and bursal-side partial rotator cuff tears, whereas no correlation was observed with articular-side tears. There was no significant difference between bursal-side and articular-side partial cuff tears regarding acromioglenoid angle, supraspinatus glenoid angle, and subacromial distance.


CONCLUSIONS
Grade 1 and grade 2 coracoacromial ligament degeneration is a strong predictive factor for impingement syndrome in the etiology of bursal-side partial cuff tears and can guide the surgeon to consider ligament release and débridement or acromioplasty in these patients.
Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey. Electronic address: ulunayk@hotmail.com.
Ulunay
U
Kanatli
Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey.
Tacettin
T
Ayanoğlu
Department of Orthopedics and Traumatology, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Erdem
E
Aktaş
Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey.
M Baybars
MB
Ataoğlu
Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey.
Mustafa
M
Özer
Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey.
Mehmet
M
Çetinkaya
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000503:physiopathology* / Q000601:surgery; D019534:Shoulder Impingement Syndrome / Q000503:physiopathology* / Q000601:surgery; D020069:Shoulder Pain / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult
Bursal-side partial rotator cuff tears; arthroscopy; articular-side partial rotator cuff tears; coracoacromial ligament degeneration; magnetic resonance imaging; subacromial impingement