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The critical shoulder angle: can it be sufficient to reflect the shoulder joint without the humeral head?
Journal of Shoulder and Elbow Surgery 2019 April
HYPOTHESIS: We hypothesized that a new method considering the humeral head would distinguish rotator cuff tears (RCTs) and osteoarthritis (OA) better than the critical shoulder angle (CSA).
METHODS: A total of 1011 patients were tested in this study and divided into 4 groups: those with RCTs (n = 493), those with OA (n = 73), those with anterior instability (n = 361), and those with adhesive capsulitis (n = 84). The CSA and new radiologic parameters including the humeral head were measured in the true anterior-to-posterior view: the Y angle connecting the lower end of the glenoid (LG), the center of the humeral head (CH), and the upper end of the glenoid (UG); the G angle connecting UG, CH, and the lateral tip of the acromion; the YG angle connecting LG, CH, and the lateral tip of the acromion; and the R angle connecting UG, LG, and CH.
RESULTS: The CSA and G angle were the largest in the RCT group (34.2° and 70.4°, respectively; P < .001) and the smallest in the OA group (29.8° and 61.7°, respectively; P < .001). The Y angle was the largest in the OA group (82.8°, P < .001). The R angle in the RCT group (52.9°) was significantly larger than that in the OA group, which was the smallest among the groups (48.0°; P < .001). The CSA was correlated with the G and YG angles in the RCT group, whereas the CSA was correlated with the Y, G, and R angles in the OA group (P < .05). The CSA showed the highest correlation with the size of RCTs (correlation coefficient = 0.138).
CONCLUSION: The Y, G, and R angles reflected the lesions of RCTs or OA. The CSA showed good correlations with the new radiologic parameters, and it had the highest correlation coefficient with the size of RCTs.
METHODS: A total of 1011 patients were tested in this study and divided into 4 groups: those with RCTs (n = 493), those with OA (n = 73), those with anterior instability (n = 361), and those with adhesive capsulitis (n = 84). The CSA and new radiologic parameters including the humeral head were measured in the true anterior-to-posterior view: the Y angle connecting the lower end of the glenoid (LG), the center of the humeral head (CH), and the upper end of the glenoid (UG); the G angle connecting UG, CH, and the lateral tip of the acromion; the YG angle connecting LG, CH, and the lateral tip of the acromion; and the R angle connecting UG, LG, and CH.
RESULTS: The CSA and G angle were the largest in the RCT group (34.2° and 70.4°, respectively; P < .001) and the smallest in the OA group (29.8° and 61.7°, respectively; P < .001). The Y angle was the largest in the OA group (82.8°, P < .001). The R angle in the RCT group (52.9°) was significantly larger than that in the OA group, which was the smallest among the groups (48.0°; P < .001). The CSA was correlated with the G and YG angles in the RCT group, whereas the CSA was correlated with the Y, G, and R angles in the OA group (P < .05). The CSA showed the highest correlation with the size of RCTs (correlation coefficient = 0.138).
CONCLUSION: The Y, G, and R angles reflected the lesions of RCTs or OA. The CSA showed good correlations with the new radiologic parameters, and it had the highest correlation coefficient with the size of RCTs.
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