Summary

Our study shows that ACEA is an effective predictor of degenerative rotator cuff tears. Patients with an ACEA > 29.88° on plain radiography were more likely to have degenerative rotator cuff tears.

Abstract

Background

The etiology of degenerative rotator cuff tears (DRCT) is unclear, although certain distinct acromion morphologies may correlate with degenerative processes. Numerous radiographic measurements attempting to describe acromion morphology have been described previously. This study aimed to validate and study the relationship between the acromiohumeral center edge angle (ACEA) and degenerative rotator cuff tears. We also aimed to compare the predictive value of ACEA to more widely studied parameters, including acromion index (AI), lateral acromion angle (LAA), and critical shoulder angle (CSA).

Hypothesis

We believe that ACEA is a valid and reliable method for predicting degenerative rotator cuff tears. Patients with higher ACEA are more likely to experience degenerative rotator cuff tears.

Study Design: Retrospective, cross-sectional study

Methods

We conducted a retrospective review of 204 shoulder radiographs obtained from patients aged = 40 years. The study population was divided into two groups based on rotator cuff status as identified by magnetic resonance imaging (MRI). We compared various radiologic parameters in 108 patients with partial and full thickness degenerative rotator cuff tears to 96 patients with intact rotator cuffs. Two independent authors measured the ACEA, AI, LAA, and CSA values on a standardized anteroposterior shoulder radiograph.

Results

The mean ACEA was significantly higher in the DRCT group than in the intact group (33.11° vs. 24.56°, p<0.001). The ACEA has excellent reliability (intraclass correlation coefficient, 0.99). The cutoff value was determined to be > 29.88° (sensitivity, 0.69; specificity, 0.78). ACEA had the best predictive value (Area under curve: 0.76) and reliability compared with AI, LAA, and CSA.

Conclusion

Our study shows that ACEA is an effective predictor of degenerative rotator cuff tears. Patients with an ACEA > 29.88° on plain radiography were more likely to have degenerative rotator cuff tears.

Clinical Relevance: This study demonstrates that the ACEA is a valid and reliable radiographic measurement that can aid in the diagnosis of degenerative rotator cuff tears in clinical settings.