Lateral acromioplasty for correction of the critical shoulder angle
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Übersicht Obere Extremität https://doi.org/10.1007/s11678-020-00578-w Received: 12 September 2019 Accepted: 14 May 2020 © The Author(s) 2020
Mark Tauber1,2 · Peter Habermeyer1 · Nikolaus Zumbansen1 · Frank Martetschläger1,3 1
Deutsches Schulterzentrum, ATOS Clinic Munich, Munich, Germany Department of Orthopaedics and Traumatology, Private Paracelsus Medical University, Salzburg, Austria 3 Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany 2
Lateral acromioplasty for correction of the critical shoulder angle
Video online The online version of this article contains one video. The article and the video are available online (https://doi.org/10.1007/ s11678-020-00578-w). The video can be found in the article back matter as “Electronic Supplementary Material”.
Background
Therefore, the purpose of this article is to describe the arthroscopic technique of acromioplasty with resection of the lateral acromion edge (LA = lateral acromioplasty)thus normalizing a pathological CSA and to report the preliminary clinical and radiological data. In contrast to former preclinical studies that used cadavers, initial clinical experiences and preliminary results of LA are reported.
Preoperative planning The bony morphology of the acromion is well known to determine mechanical outlet impingement and represents a risk factor for the development of rotator cuff tear (RCT; [4, 18]). In 1986, Bigliani et al. [4] introduced the wellestablished classification including three types of acromion shape in the outlet view. However, no statistically significant correlation could be shown in regard to RCT. Among others, the critical shoulder angle (CSA) represents a significant radiological parameter correlated with RCT, first described by Moor et al. [17]. It is defined by a line through the superior and inferior glenoid poles and a second line through the inferior glenoid pole and the lateral acromion edge (. Fig. 1). Resection of the lateral acromion edge in patients with a pathological CSA and RCT is suggested in order to normalize the CSA and to prevent RC re-tearing. To date, only cadaveric studies exist describing the influence of lateral acromion resection on the CSA.
The CSA is measured on a true anteroposterior (AP) view with a commonly available digital measuring software (. Fig. 1a). The gleno-acromial line (defined by the inferior glenoid pole and the lateral acromion edge) is then moved medially until the digital angle measurement tool shows a normal CSA (
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