Os acromiale

Os acromiale is a developmental defect which results from the lack of an osseous union between the ossification centers of the acromion, leading to the fibrocartilaginous tissue connection. The prevalence of os acromiale is 1% to 15%, and is quite common in the African American population. Os acromiale in adults is easily diagnosed by symptoms and X-ray, particularly on the axillary view; however, the differential diagnosis of adolescents may require MRI or SPECT-CT. Generally, nonoperative therapy for symptomatic os acromiale should be started, including physiotherapy, nonsteroidal anti-inflammatory drugs, and injections...

Os acromiale represents an unfused accessory centre of ossification of the acromion of scapula. It may cause shoulder impingement, rotator cuff tear or degenerative acromio-clavicular joint disease. A 38-year-old male with history of degenerative disc disease presented with persistent backache. MRI of the lumbar spine had earlier showed left paracentral disc protrusion of L5/S1 vertebrae impinging the left S1 nerve root for which the patient underwent fluoroscopic guided nerve root block. Due to persistent bilateral sciatica and worsening leg pain a decompression surgery was planned...

BACKGROUND: The literature is unclear as to the optimal surgical management of a symptomatic os acromiale that has failed nonoperative treatment. Surgical options include excision, acromioplasty, and open reduction and internal fixation. The purpose of this study is to summarize the described methods and compare their reported outcomes with the goal to provide direction on how to surgically manage os acromiale. METHODS: We performed a systematic review of the current medical literature...

OBJECTIVE: Arthroscopic anterior acromioplasty (AAAP) for treatment of symptomatic subacromial spur. Arthroscopic lateral acromioplasty (ALAP) to reduce a pathological critical shoulder angle (CSA) and prevent rotator cuff re-tear after reconstruction. INDICATIONS: AAAP is indicated for acromial impingement due to an anterolateral acromial spur with or without bursa-sided rotator cuff lesion. ALAP is indicated concomitant to arthroscopic rotator cuff repair if the CSA is pathologically increased...

Background: The effect of a pre-operative compromised acromion on reverse shoulder arthroplasty (RSA) is not well-studied. Purposes/Questions: We sought to determine the effect of a pre-operative compromised acromion on outcomes following RSA. Methods: We conducted a retrospective case-control study of consecutive patients who underwent RSA over a 6-year period (June 2007 to June 2013) with a diagnosis of rotator cuff tear arthropathy. Pre-operative plain radiographs were examined to determine the presence of acromion compromise ( n  = 11)...

INTRODUCTION: Anatomical variations of the lateral offset of the acromion (LOA) are supposed to be a factor favoring of the development of rotator cuff tears. The primary objective of this study is to quantify the inter-individual variations of the lateral offset of the acromion. METHODS: The morphology of 103 dried scapula was studied. Scapula with an os-acromiale, fractures and osteoarthritic changes of the glenoid cavity were excluded. We measured the distance between the medial edge of the spine and the supra-glenoidal tubercle of the glenoid fossa (L0 ), as well as the distance between this medial point and the most lateral point of the acromion (Lmax )...

INTRODUCTION: The purpose of this study is to investigate the incidence of os acromiale in patients who had reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy and the effect of presence of os acromiale on the functional results. HYPOTHESIS: We hypothesize than in the presence of os acromiale, the contraction strength of the deltoid would decrease due to the dynamic downward depression of the bony fragment leading to less favorable clinical results...

BACKGROUND: This review compares the outcomes and complication rates of three surgical strategies used for the management of symptomatic os acromiale. The purpose of this study was to help guide best practice recommendations. METHODS: A systematic review of nine prospective studies, seven retrospective studies, and three case studies published across ten countries between 1993 and 2018 was performed. Adult patients (i.e., ≥ 18 years of age) with a symptomatic os acromiale that failed nonoperative management were included in this review...

BACKGROUND: The purpose of this paper was to survey members of the American Shoulder and Elbow Surgeons (ASES) to assess their opinion on management options, help highlight important clinical factors, and elucidate surgical preferences for the treatment of a symptomatic meso-os. METHODS: An online questionnaire was distributed to the active members of the ASES. The survey queried surgeon demographics and perioperative management preferences, and presented multiple clinical case scenarios of patients with a presumed symptomatic, unstable os acromiale...

OBJECTIVE: To evaluate the relationships between acromial anatomy and developmental alterations with rotator cuff tears in female patients and compare these parameters on radiographs and corresponding MRIs along with inter-reader performance. MATERIALS AND METHODS: Patient demographics, symptoms, and acromial characteristics on radiograph (acromial index, lateral acromion angle, subacromial space on AP and Y- views, acromial anterior and lateral downsloping) and MRI (shape, slope, spur, osteoarthrosis, os acromiale) were recorded...

Os acromiale is a failure of fusion between 1 or more ossification centers of the scapula and the acromion process. Pain can be caused by motion and impingement of the unfused segment. Several methods for the management of os acromiale have been described. Internal fixation is the most common surgical technique, followed by excision and acromioplasty. We present a novel technique for treatment of symptomatic os acromiale using arthroscopically-guided headless compression screws. This is a viable technique in the management of symptomatic os acromiale due to preservation of the periosteal blood supply and less concern for symptomatic hardware...

Management of a persistently symptomatic, unstable os acromiale remains controversial. An unstable os acromiale is an easy diagnosis to miss and should be specifically evaluated for in patients with shoulder pain and a high degree of clinical suspicion. Surgical options include open or arthroscopic excision and open reduction and internal fixation. Open excision of large fragments has had poor results. Arthroscopic treatment is commonly used for small fragments (preacromion), and the technique has also been used in larger fragments (meso-os), but concerns persist over postoperative weakness secondary to shortening of the deltoid lever arm...

Background: Os acromiale is a rare condition mostly reported in the literature through case reports, imaging studies, or reports of surgical treatment. This condition is the result of nonunion of growth plates of the acromion during the natural developmental process that occurs between 15 and 25 years of age. Its incidence is low, and few studies are available in the literature on athletes with high functional demands, and particularly on athletes within a specific sport. Purpose: To collect epidemiological data and to report the amount of time out of play as well as the type of treatment and its efficiency in professional tennis players...

BACKGROUND: Symptomatic os acromiale are fairly uncommon, and treatment has included fragment excision, decompression, and open reduction and internal fixation. Nonunion rates as high as 40% have been reported after fixation of os acromiale. This study assessed whether union of an os acromiale could be reliably achieved without the use of an iliac crest bone graft. METHODS: This was a retrospective study of 32 consecutive shoulders that were treated with screw fixation and a local bone graft or iliac crest bone graft...

Many radiologists are familiar with the preoperative imaging assessment of patients with labral tears, rotator cuff abnormalities, and end-stage arthritis, as well as the subsequent primary reconstructions and repairs commonly encountered in routine clinical management. However, the second-line surgical procedures and augmentation procedures performed for refractory or recurrent shoulder instability and the extra-articular surgical procedures of the shoulder girdle may challenge even the most experienced musculoskeletal radiologist...

BACKGROUND: A symptomatic os acromiale can lead to impingement syndrome and rotator cuff tendinopathy. An acromion fracture is often part of a more complex scapular trauma that needs stabilisation. METHODS: We developed a new technique using a three-dimensional (3D) model and a distal clavicle reconstruction plate to treat os acromiale and acromion fractures. Our hypothesis was that such an approach would be a useful addition to the existing techniques. First, a 3D model of the acromion was printed, then an osteosynthesis plate was pre-bent to fit the exact shape and curve of the acromion...

Os acromiale occur frequently in the population and can be a cause of significant shoulder dysfunction and rotator cuff impingement. When symptomatic os acromiale fail conservative management, surgical intervention may become necessary. The purpose of this article is to describe our preferred surgical technique for osteosynthesis of os acromiale using cannulated screws and tension-band wiring.

BACKGROUND: Os acromiale has been reported in up to 15% of the general population. Reverse total shoulder arthroplasty (RTSA) increases deltoid tension, which could potentially lead to excessive stress on a pre-existent os acromiale. The purpose of this study was to determine the outcome and complications of primary RTSA in patients with radiographic evidence of an os acromiale. METHODS: Between 2005 and 2013, 25 shoulders underwent primary RTSA with an associated os acromiale, which was classified preacromion (3), mesoacromion (20), and meta-acromion (2)...

The surgical technique for the management of a symptomatic os acromiale remains unclear. Several operative techniques have been described including open excision, open reduction-internal fixation (ORIF), arthroscopic acromioplasty or subacromial decompression, and arthroscopic excision. There are 4 types of os acromiale, with the meso-acromion being the most common and difficult to treat. The excision of a pre-acromion arthroscopically or in an open manner usually produces satisfactory results. However, the open excision of a meso-acromion can lead to persistent pain and deltoid weakness and atrophy...

Os acromiale consist in a lack of fusion between the different ossification spots of the acromial side of scapula from the age of 23-25 years. A relation between os acromiale and some shoulder pathology like impingement syndrome, cuff tear and subacromial bursitis has been described. The etiology is not already known. The aim of this study was to evaluate the frequency of os acromiale in our population, the link between os acromiale and sex, side and shoulder pathology. 1042 shoulder MRI were evaluated to find out os acromiale and the linked cuff pathology...