Summary

This study evaluated the relationship between the Bigliani acromion classification and rotator cuff and biceps tears.

Abstract

Purpose

This retrospective study analyzed the relationship between Bigliani acromion classification on both rotator cuff tears and bicep tendon tears in order to more accurately describe rotator cuff and bicep tendon pathology.

Methods

The study population consisted of 198 patients who underwent arthroscopic shoulder surgery from 2006 to 2014. MR imaging was used to evaluate the presence of Type I (flat), type II (curved), or Type III (hooked) Bigliani acromion classifications. The presence of partial-thickness or full-thickness rotator cuff tears and partial-thickness or full-thickness biceps tendon tears were evaluated at the time of surgery.

Results

There was no significant (p = .091, 1 - ß = 0.49, a = 0.05, ß = 0.51) relationship between acromion type and rotator cuff tears. There was also no significant (p = .071, 1 - ß = 0.52, a = 0.05, ß = 0.48) relationship between acromion type and biceps tendon tears. A larger prevalence of acromion type II tears was noted, which may be attributable to a relatively older mean population age of the study subjects (mean age = 56.6 ± 12.4 years). Type II acromion classifications showed a larger prevalence (33.3%) for biceps tears while Type I acromion classifications showed a larger prevalence (62.5%) for rotator cuff tears.

Conclusion

Variations in acromion anatomy as defined by Bigliani acromion classification does not influence rotator cuff tear or bicep tendon tear pathology. These findings contradict previous theories that explained rotator cuff injury as a result of impingement of the acromion on the rotator cuff tendons.
Levels of Evidence: Level II, Retrospective Cohort Study