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At least 1,243 records · Page 69Linked to original sources
PubMed2006

Decreasing glenoid inclination improves function in shoulders with simulated massive rotator cuff tears.

BACKGROUND: A massive rotator cuff tear leads to poor shoulder function as evidenced by diminished glenohumeral abduction and superior translation of the humeral head compared to its normal position. The inclination angle of the glenoid has been associated with rotator cuff tears. The objective of this study was to quantify the effect of a decreased glenoid inclination angle on glenohumeral kinematics during active abduction in shoulders with a simulated, massive rotator cuff tear. METHODS: Eight fresh-frozen full upper extremities were tested using a dynamic shoulder testing apparatus. After recording the kinematics of the intact shoulder, a massive rotator cuff tear was surgically simulated. An osteotomy of the glenoid was then performed and the inclination angle was decreased by 30 degrees . The translation of the humeral head during abduction and the maximum abduction angle were recorded. FINDINGS: With an intact rotator cuff minimal humeral head translation on the glenoid occurred and the maximum abduction angle was mean 85.5 degrees (SD 7.4 degrees ). A massive rotator cuff tear resulted in superior translation of the humeral head with impingement on the acromion. The maximum abduction angle was mean 15.5 degrees (SD 9.4 degrees ). Decreasing the inclination angle of the glenoid resulted in a significant reduction of superior humeral head translation during abduction and there was no impingement on the acromion. The maximum abduction achieved was mean 28.5 degrees (SD 17.0 degrees ). INTERPRETATION: From a clinical perspective the reduced superior translation may decrease shoulder pain since the humeral head no longer impinges on the acromion. Further investigations are necessary to assess if the improvement in abduction is clinically significant.

Cadaver↗
PubMedDate not supplied

Differential patterns of muscle activation in patients with symptomatic and asymptomatic rotator cuff tears.

Patients with rotator cuff tears have varying degrees of symptom expression. Our purpose was to evaluate the differential firing patterns of the rotator cuff, deltoid, and scapular stabilizer muscle groups in normal control subjects and in patients with symptomatic and asymptomatic 2-tendon rotator cuff tears. Eighteen subjects were evaluated: six normal subjects and twelve with 2-tendon cuff tears (six asymptomatic and six symptomatic). All cuff tear patients had magnetic resonance imaging (MRI) scans documenting superoposterior tear configurations involving the supraspinatus and infraspinatus tendons; all normal subjects had an ultrasound examination confirming the absence of cuff pathology. Subjects were grouped based on shoulder examination and outcomes questionnaires. Asymptomatic patients had minimal pain (<3 on the visual analog scale and no loss of active range of motion compared with the contralateral side); symptomatic patients had pain greater than 3 on the visual analog scale and decreased range of motion compared with the contralateral side (>10 degrees of motion loss). Electromyographic activity from 12 muscles and kinematic data were collected simultaneously during 10 functional tasks. Both symptomatic and asymptomatic cuff subjects demonstrated a trend toward increased muscle activation during all tasks compared with normal subjects. During the internal rotation tasks, asymptomatic patients had significantly greater (P<.05) subscapularis activity than symptomatic patients (65% maximal voluntary contraction [MVC] vs 42% MVC). During the carrying task, asymptomatic patients demonstrated significantly less (P<.03) upper trapezius muscle activation than symptomatic patients (16% MVC vs 50% MVC). During shoulder elevation tasks, symptomatic patients had significantly greater supraspinatus (52% MVC vs 28% MVC, P<.03), infraspinatus (32% MVC vs 16% MVC, P<.05), and upper trapezius (39% MVC vs 20% MVC, P<.04) muscle activation compared with asymptomatic patients. During heavy elevation (8 lb), asymptomatic patients showed a trend toward increased activation (P<.06) of the subscapularis compared with symptomatic patients (34% MVC vs 21% MVC). Differential shoulder muscle firing patterns in patients with rotator cuff pathology may play a role in the presence or absence of symptoms. Asymptomatic subjects demonstrated increased firing of the intact subscapularis, whereas symptomatic subjects continued to rely on torn rotator cuff tendons and periscapular muscle substitution, resulting in compromised function.

Adult↗
PubMedDate not supplied

Arthroscopic tenotomy of the long head of the biceps in the treatment of rotator cuff tears: clinical and radiographic results of 307 cases.

The purpose of this study is to evaluate the objective, subjective, and radiographic results of arthroscopic biceps tenotomy in selected patients with rotator cuff tears. Three hundred seven arthroscopic biceps tenotomies were performed in patients with full- thickness rotator cuff tears. Patients were selected for arthroscopic tenotomy if the tear was thought to be irreparable or if the patient was older and not willing to participate in the rehabilitation required after rotator cuff repair. Patients were evaluated clinically and radiographically at a mean of 57 months' follow-up (range, 24-168 months). The mean Constant score increased from 48.4 points preoperatively to 67.6 points postoperatively ( P < .0001). Eighty-seven percent of patients were satisfied or very satisfied with the result. The acromiohumeral interval decreased by a mean of 1.3 mm during the follow-up period and was associated with a longer duration of follow-up ( P < .0001). Preoperatively, 38% of patients had glenohumeral arthritis; postoperatively, 67% of patients had glenohumeral arthritis. Concomitant acromioplasty was statistically associated with better subjective and objective results only in patients with an acromiohumeral distance greater than 6 mm. Fatty infiltration of the rotator cuff musculature had a negative influence on both the functional and radiographic results ( P < .0001). Arthroscopic biceps tenotomy in the treatment of rotator cuff tears in selected patients yields good objective improvement and a high degree of patient satisfaction. Despite these improvements, arthroscopic tenotomy does not appear to alter the progressive radiographic changes that occur with long-standing rotator cuff tears.

Acromion↗
PubMedDate not supplied

Pathogenesis of partial tear of the rotator cuff: a clinical and pathologic study.

This prospective study investigated the clinical and pathologic results in 66 patients with partial tears of the rotator cuff from January 1996 to December 1998. The pathologic change in the rotator cuff was graded from the magnetic resonance images by using the criteria described by Zlatkin and Iannotti. A modified grading system from Ozaki and Panni was used for pathologic grading of the anterior acromion. The functional score of Constant and Murley was used for clinical assessment. The pathologic change in the rotator cuff revealed by the magnetic resonance imaging study was more severe in patients with articular side tears compared with patients who had bursal side tears. On the contrary, the pathologic changes in the acromion were significantly milder in patients with articular side tears compared with bursal side tears. These observations indicate that articular side tears of the rotator cuff are mainly associated with intrinsic pathologic changes of the rotator cuff, whereas bursal side tears are associated with subacromial impingement on an underlying milder pathologic change of the rotator cuff.

Acromion↗
PubMed2006

Effect of rotator interval closure on glenohumeral stability and motion: a cadaveric study.

The effect of rotator interval closure, which is performed as an adjunct to arthroscopic stabilization of the shoulder, has not been clarified. Fourteen fresh-frozen cadaveric shoulders were used. The position of the humeral head was measured using an electromagnetic tracking device with the capsule intact, sectioned, and imbricated between the superior glenohumeral ligament and the subscapularis tendon (SGHL/SSC closure) or between the superior and middle glenohumeral ligaments (SGHL/MGHL closure). The direction of translational loads (10, 20, and 30 N) and arm positions were (1) anterior, posterior, and inferior loads in adduction; (2) anterior load in abduction/external rotation in the scapular plane; and (3) anterior load in abduction/external rotation in the coronal plane. The range of motion was measured using a goniometer under a constant force. Both methods reduced anterior translation in adduction. Only SGHL/MGHL closure reduced anterior translation in abduction/external rotation in the scapular plane and posterior translation in adduction. Both methods reduced the range of external rotation and horizontal abduction. Rotator interval closure is expected to reduce remnant anterior/posterior instability and thereby improve the clinical outcomes of arthroscopic stabilization procedures.

Adult↗
PubMed2006

MR imaging of the rotator cuff.

MR imaging is the optimal method for evaluating suspected rotator cuff pathology. Current techniques of fast spin-echo imaging without and with fat suppression allow accurate identification and characterization of tendinous and myotendinous abnormalities of the rotator cuff. Impingement disorders, tendon degeneration, instability,and trauma comprise the multifactorial nature of rotator cuff disease. This article addresses the role of MR imaging in evaluating the rotator cuff and the importance of MR imaging in identifying other lesions that may mimic rotator cuff pathology. A rationale for protocol design, including MR arthrography and the use of specialized positioning, such as abduction and external rotation (ABER), are discussed.

Humans↗
PubMed1997

Biology of the rotator cuff tendon.

Tendons are complex composite material composed primarily of water, collagen, proteolycans, and cells, designed to transmit tensile loads from muscle to bone. Although rotator cuff tendons differ in many ways from other tendons in the body, a knowledge of basic tendon structure and function is helpful in understanding rotator cuff tendon biology, injury, and repair. In addition to type I collagen, rotator cuff tendons contain small amounts of type III collagen, which play a role in healing and repair. In comparison with other tendons, the increased glycosaminoglycan and proteoglycan content seen in rotator cuff tendons may be adaptive, pathologic, or both. The etiology of rotator cuff pathology is probably related to trauma, aging, and degeneration. As our understanding of these processes increases, we will be able to develop and implement improved preventative and therapeutic interventions for rotator cuff pathology.

Animals↗
PubMed2006

[Bipolar shoulder prosthesis for rheumatoid arthritis with irreparable rotator cuff tear: results after 5 years' follow-up].

PURPOSE OF THE STUDY: The goal of this study was to assess the clinical and radiological outcome of bipolar shoulder prosthesis in twelve shoulders with rheumatoid arthritis (RA) and irreparable rotator cuff tears. MATERIAL AND METHODS: The follow-up was more than five years (range 2-9 years). In addition, in order to investigate the effect of rheumatoid arthritis on outcome, results were compared with ten bipolar shoulder prostheses implanted for osteoarthritis with massive rotator cuff tears. RESULTS: The mean preoperative Constant score was 16.9 points with 2.6 points for pain, 4.2 points for activity, 9.5 points for motion and 0.6 points for force. The preoperative active motion was 63.8 degrees for forward flexion, 45 degrees for abduction and 12 degrees for active external rotation. At last follow-up, the average Constant score was 39.4 points with 10.7 points for pain, 10.8 points for activity, 13.8 points for motion and 4.1 points for force. Regarding the active motion, mean forward flexion was 83.7 degrees, 70.4 degrees for abduction and 29.1 degrees for external rotation. The complication rate was low, mainly superior migration due to infraspinatus tear and glenoid wear. Satisfactory deltoid arm level was achieved in all patients and no loosening was observed. Preoperative and postoperative scores of the rheumatoid group were not significantly different from the arthritis group (p<0.001). DISCUSSION: Our findings suggest that bipolar shoulder prosthesis provides a viable replacement alternative in RA combined with massive rotator cuff tear with a low rate of complication. Bipolar shoulder prosthesis demonstrates no clear superiority over conventional hemiarthroplasty regarding improved motion and glenoid wear. In addition, no significant difference with arthritis was observed (p<0.05), assuming that outcome depends principally on the preoperative condition of the rotator cuff. CONCLUSION: Some massive tears involving the subscapularis tendon can lead to anterior recurrence after bipolar shoulder prosthesis. They might be a limit to the procedure and require a reversed shoulder prosthesis or a glenohumeral arthrodesis.

Aged↗
PubMed2000

Repair of the rotator cuff. Mini-open and arthroscopic repairs.

The repair of rotator cuff tears by traditional open subacromial decompression and rotator cuff tendon reapproximation has proved successful in restoring function and decreasing pain, but open rotator cuff repair has some inherent disadvantages. Postoperative detachment of the deltoid repair has been reported and results in significant morbidity. The open technique may also require a longer period of limited motion resulting in greater stiffness. Arthroscopically assisted mini-open repairs and, more recently, completely arthroscopic repairs of the rotator cuff have been developed and increasingly are being applied. Both techniques avoid detachment of the deltoid. The mini-open and arthroscopic approaches to rotator cuff repair have the added benefit of arthroscopic evaluation of the glenohumeral joint. The mini-open technique has the advantage of allowing the direct visualization of the cuff repair and allows surgeons to place the stitches in an open fashion, which is familiar to all surgeons. The mini-open technique also allows the placement of tension-absorbing stitches in the rare cases that they are needed. Mini-open techniques also allow the choice of bone anchors or osseous tunnels for fixation. The completely arthroscopic cuff repair has several potential advantages over the open and mini-open cuff repair techniques; first is the decreased disruption of the soft tissues, which may result in less scarring and adhesions. The procedure is the most cosmetically appealing of the techniques. Reduced postoperative pain is also cited as an advantage but has been demonstrated only in a single, nonrandomized study. Finally, if technical difficulties arise, the conversion to a mini-open repair can be done easily. In a few studies, arthroscopic cuff repair techniques have shown promise as an alternative to mini-open or open repair, but these results have been at the hands of a few surgeons who have extensive experience in arthroscopy of the shoulder. In contrast, the mini-open procedure requires modest arthroscopic skills and has a documented history of success. Nevertheless, arthroscopic rotator cuff repair is a viable and effective technique in the hands of surgeons with adequate skills, and this procedure is likely to become more commonly performed in the future as shoulder arthroscopic skills and instrumentation improve.

Arthroscopy↗
PubMed2001

The presence of smooth muscle actin in fibroblasts in the torn human rotator cuff.

The rotator cuff frequently sustains athletic and occupational injury, often resulting in chronic pain and disability. However, despite the high incidence of such shoulder problems, the pathophysiology of rotator cuff injury and healing has not yet been fully elucidated. The notable finding of this study was the presence of a contractile actin isoform, alpha-smooth muscle actin (SMA), in nonvascular cells in all of the seven torn human rotator cuff specimens evaluated immunohistochemically. Up to 95% of cells in any one region, and over 95% of elongated cells found in association with crimped collagen, contained SMA. Most of the cells staining positive for SMA in these sections had morphological features of the fibroblast, though a small number were chondrocyte-like. Treatment of cells growing out from human rotator cuff explants with TGF-beta1 significantly increased the amount of SMA evaluated by Western blot analysis. PDGF-BB and IFN-gamma had no effect on the cell content of SMA. This is the first documentation of the presence of SMA-positive cells in the human rotator cuff tendon. SMA has been found in a number of other healing connective tissues including skin, ligament, meniscus, cartilage, and other types of tendon. Of importance are previous findings that SMA-positive cells can contract a collagen-glycosaminoglycan analog of extracellular matrix in vitro. The results of the present study thus suggest that SMA-containing cells could contribute to the retraction of the torn ends of a ruptured rotator cuff and play an important role in healing.

Actins↗
PubMed2006

Imaging factors related to rotator cuff tear in patients with deltoid contracture.

BACKGROUND: Bony deformity and muscular malfunction around the shoulder induced by deltoid contracture may influence rotator cuff function and lead to subsequent tearing. The purpose of this study was to investigate the imaging and clinical factors related to rotator cuff tear in patients with deltoid contracture. METHODS: We retrospectively reviewed 48 shoulders in 44 patients with magnetic resonance imaging diagnosis of deltoid contracture and surgically-proven rotator cuff tear. These shoulders were subdivided into partial-thickness and full-thickness tear groups. Another 17 shoulders in 17 patients with deltoid contracture but no evident rotator cuff tear were included as the control group. The characteristics, including age, gender and imaging features, of these three groups were compared. RESULTS: Two patients who underwent initial operations for cuff tears required secondary operations for distal release of deltoid contracture. The age of patients with full-thickness tear was significantly greater than that of patients with partial-thickness tear or without tear. The winging angle of the glenoid (WAG) in the full-thickness tear group was significantly greater than that in the partial-thickness tear group. Patients with partial-thickness tear also had greater WAG than those without tear. However, WAG was not significantly correlated with the fibrotic size or age of the patient. CONCLUSION: In patients with deltoid contracture, age and WAG are associated with the development of rotator cuff tear. To prevent the occurrence of rotator cuff tear, early surgical release of deltoid contracture is highly recommended, especially in patients with greater WAG.

Adult↗
PubMedDate not supplied

Arthroscopic treatment of rotator cuff disease.

Rotator cuff disease represents a spectrum of tendon lesions including inflammation of an intrinsically normal tendon, tendon fibrosis, partial-thickness tears, complete tears, and cuff tear arthropathy. An in-depth analysis of the entire subject is beyond the scope of this article. This article will focus on the arthroscopic management of the spectrum of rotator cuff disease in an attempt to provide a timely summary of the present state of knowledge. Five stages of rotator cuff disease will be reviewed: stage 2 impingement, partial-thickness cuff tears, complete-thickness rotator cuff tears, irreparable rotator cuff tears, and cuff tear arthropathy. In preparing this article I have assumed that the reader is familiar with the diagnosis of rotator cuff lesions through the use of appropriate patient history, physical examination, and radiologic studies.

Acromioclavicular Joint↗
PubMedDate not supplied

Arthroscopic-assisted rotator cuff repair: patient selection and treatment outcome.

Over a 4-year period 24 patients out of 376 who required a rotator cuff repair were selected for arthroscopic-assisted rotator cuff repair. Preoperative selection criteria were refractory pain in the setting of good range of motion and strength (after an impingement test), absence of radiographic superior humeral head translation, and magnetic resonance imaging evidence of minimally retracted tear without rotator cuff muscle atrophy. Intraoperative selection criteria were the findings of an avulsion-type tear configuration with good tendon quality and absence of subscapularis tendon involvement. Based on these intraoperative criteria, 7 of the 24 patients were converted to an open approach to mobilize retracted and friable tendon tissue in a complex tear configuration. The remaining 17 patients underwent a transosseous arthroscopic-assisted rotator cuff repair with an average postoperative follow-up of 23 months. Evaluation by an independent therapist determined the postoperative American Shoulder and Elbow Surgeons Shoulder Function Index of 96 +/- 3 for the operative shoulder. The Functional Rating Scores for Activities of Daily Living and Sports Activity Score were 89% +/- 10% and 87% +/- 12%, respectively. Instrumented isometric strength for abduction and external rotation strength in the operated shoulder were 94% +/- 20% and 93% +/- 20%, respectively, compared with the contralateral unoperated side. Five of eight patients who performed overhead sports returned to a premorbid level of performance, and 14 of 15 patients available for follow-up believed that their result was excellent. We conclude that through careful selection one can identify patients optimally suited for arthroscopic-assisted rotator cuff repair, but some may have to be converted to an open end approach because of the quality of the tendon tissue and configuration of the tear requiring soft tissue releases.

Activities of Daily Living↗
PubMedDate not supplied

The low incidence of suprascapular nerve injury after primary repair of massive rotator cuff tears.

We measured the incidence of cuff retear and injury to the suprascapular nerve after mobilization and repair of a massive rotator cuff tear. Of one hundred four rotator cuff repairs performed over a 5-year period, 10 patients (7 men and 3 women, age range 22 to 68 years) had primary repairs of massive rotator cuff tears requiring cuff mobilization and an acromioplasty as their only procedure. These patients were evaluated at a mean of 2.5 years (range 2.0 to 3.0 years) after surgery. At follow-up electromyographic examination confirmed that 1 of the 10 patients had an iatrogenic suprascapular nerve injury, whereas ultrasound evaluation revealed that 2 of 10 repairs failed. Pain relief was achieved in the eight patients with intact repairs and not in the two with recurrent tears. All patients had some limitation of active motion or strength, especially in external rotation. Thus 7 of 10 patients had neither evidence of nerve injury nor recurrent rotator cuff tears yet still showed limited active motion or weakness. It appears that operative injury to the suprascapular nerve during cuff mobilization can occur, but other factors such as inadequate cuff muscle function are more frequently responsible for the poor functional outcomes seen after successful repairs of massive rotator cuff tears.

Adult↗
PubMed2002

The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years.

PURPOSE: To discuss a new technique for the surgical treatment of type II SLAP lesions as well as the evaluation of the technique's effectiveness with a minimum 2-year follow-up. TYPE OF STUDY: Retrospective clinical follow-up study. METHODS: We present a clinical follow-up of 31 patients who were treated arthroscopically for type II SLAP lesions using a trans-rotator cuff portal at an average follow-up time of 3.7 years. Patients were screened for concomitant procedures including rotator cuff repairs, shoulder stabilizations, thermal capsullographies, and previous surgeries. These patients were subsequently excluded from the study. Patients were given a standard physical examination of the upper extremity at our institution and they completed both the L'Isalata and American Shoulder and Elbow Surgeons questionnaires. RESULTS: All 31 patients identified were available for follow-up at an average time of 3.7 years postoperatively (range, 2.0 to 7.4 years). The average L'Insalata score was 87.0 points (range, 46.1-100 points); the average ASES score was 87.2 points (range, 46.7-100 points). The average pain score was 1.5 (range, 0-5) and only 4 of the 31 patients complained of moderate pain with activity. Sixteen of the 31 patients returned to their preinjury level of sports; 11 of the 31 patients returned to limited activity and 2 patients were inactive at the time of follow-up. Overall satisfaction with the procedure averaged 3.79 points (range, 0-5 points): 22 patients rated overall satisfaction as good or excellent, 6 patients reported a fair outcome, and only 3 patients were unsatisfied with the results of the surgery. One patient who was unsatisfied with the procedure had reinjured his superior labrum and required a second operation. None of the 31 patients had symptoms suggestive of rotator cuff pathology. Of the 30 patients found to have a positive Active Compression test preoperatively, 26 of these patients now had a negative sign. CONCLUSIONS: The trans-rotator cuff approach allows for a more optimal placement of a biodegradable fixation device and/or suture anchors into the superior labrum. Furthermore, we believe that this approach does not compromise the function of the rotator cuff. The trans-rotator cuff technique is an effective and safe modality to address superior labral pathology.

Accidents, Traffic↗
PubMed2005

[Efficacy of home exercises for symptomatic rotator cuff tears in correlation to the size of the defect].

AIM: Although the outcome of surgical treatment of rotator cuff tears is well documented in the literature, less is known about the efficacy of home exercises for symptomatic rotator cuff tears in correlation to the size of the defect. METHODS: A series of 30 patients (38 shoulders) with rotator cuff tears seen by ultrasonography were included in this prospective study. Rotator cuff tears were divided into partial defects (group A), full thickness tears of the supraspinatus tendon (group B), and massive rotator cuff defects (group C). Treatment consisted of a home program of stretching and strengthening exercises that were performed by the patients daily for a period of 12 weeks and controlled by a physician every 2 weeks. Range of motion, a modified constant score, and impingement signs at initial examination and after 12 weeks were compared. RESULTS: All groups experienced improvement in range of motion. The Constant scores improved significantly (p < 0.05) in all groups (A: 13.0 [+/- 7.9 SD], B: 13.2 [+/- 11.4 SD], and C: 17.5 [+/- 6.6 SD]). Impingement signs showed a downward trend in all groups. DISCUSSION: The results of this study show that patients with rotator cuff defects do benefit from simple home exercises independent from the size of the defect.

Adult↗
PubMedDate not supplied

[Rupture of the rotator cuff].

Reconstructive surgery of rotator cuff tears tries to restore a stable center of rotation in the shoulder joint. Both the classic technique of open surgery and the arthroscopic technique are employed to reconstruct the rotator cuff. This review tries to answer the question which of both surgical techniques is superior by a review of the literature. The recent literature demonstrates a shorter follow-up period for publications concerning arthroscopic reconstruction (mean 3 years) in comparison to open surgery, where follow-up is in mean 6.2 years. Overall arthroscopic surgery achieves good and excellent results between 68 to 96%, open reconstruction between 77 and 91%. Longevity of reconstructed rotator cuffs especially in large tears seems to be significantly shorter if an arthroscopic technique was used. Several authors mentioned size of tear as a major factor influencing longevity. However in patients treated arthroscopically despite rerupture of the rotor cuff patient's satisfaction and clinical outcome is still very good in short-term follow-up. In case of a complete tear of one tendon of the rotator cuff the arthroscopic technique seems to be superior. If large tears occur (two or three tendons) the open surgical technique may be more reliable with regard to longevity of the repair. For the future it seems necessary to obtain long-term results to be able to compare both principles of reconstruction of the rotator cuff. Furthermore these future studies should include quality of life scores as measurements tools besides the already employed parameters as size of the tear, age at surgery, patient satisfaction and outcome scores.

Arthroscopy↗
PubMedDate not supplied

Radiographic findings associated with symptomatic rotator cuff tears.

This study compared shoulder radiographs of patients with a documented rotator cuff tear with those of asymptomatic age-matched controls. Radiographs of 40 subjects with documented rotator cuff tears were evaluated along with similar films of 84 asymptomatic age-matched controls. Three radiographs were taken of each shoulder: (1) acromioclavicular joint view, (2) anterior-posterior view with 30 degrees of external rotation, and (3) supraspinatus outlet view. Two fellowship-trained radiologists interpreted 14 radiographic areas in a blinded fashion. Inspection of the greater tuberosity showed large positive abnormal ratings for sclerosis, osteophytes, subchondral cysts, and osteolysis. No association was noted between acromial morphology and rotator cuff tears. These results indicate that shoulder radiographs of subjects with a documented rotator cuff tear have greater tuberosity radiographic abnormalities that are not noted in asymptomatic subjects without a rotator cuff tear. No relationship was found between tear length and any of the degenerative conditions.

Acromion↗