Purpose
The purpose of this study was to determine whether a relationship existed between
primary adhesive capsulitis and acromial morphology.
Type of study
Case control series.
Methods
Between January 1999 and June 2002, a total of 100 patients (104 shoulders) were diagnosed
with adhesive capsulitis. A retrospective chart review was performed of all of these
patients. A total of 67 patients (69 shoulders) met the inclusion criteria of primary
adhesive capsulitis. The patients’ range of motion and signs of impingement were documented.
The supraspinatus outlet radiographs were assessed, and each patient’s acromial morphology
was graded as type I, II, or III. A case control group of 53 patients (58 shoulders)
was assessed to determine the validity of our results. This group consisted of a series
of new patients that were referred to the clinic during February 2003 for assessment
of their shoulders.
Results
The average age of the patients in the adhesive capsulitis group was 52.5 ± 7.6 years,
with 34 women (50.7%) and 33 men (49.3%). The control group had an average age of
51.1 ± 16.9 years in a series of 19 (35.8%) women and 34 (64.2%) men. The average
range of motion was 98.0° ± 23.5° of forward elevation, and 91.9° ± 24.3° of abduction.
The forward elevation was 165.5° ± 15.3° and the abduction was 162.4° ± 18.4°. The
predominant acromial morphology in both groups in this study was a type II acromion
(75.4% in the adhesive capsulitis group and 74.1% in the control group). The χ-square
analysis within the specific groups showed statistically significant differences in
the number of type II compared with type I acromions, and type II compared with type
III acromions in both series. However, statistical analysis showed no significant
difference between the various acromial types when comparing the adhesive capsulitis
group with the control group.
Conclusions
Our results show a significant number of patients with both adhesive capsulitis and,
in the control group, type II acromions. We found no statistical difference between
these 2 groups. Based on our results, the intrinsic trauma that occurs from subacromial
space narrowing caused by the anterior acromial shape, cannot be implicated as the
cause of primary adhesive capsulitis.
Level of evidence
Level III, case control study.
Key words
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© 2004 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
