Purpose
Assessment on whether radiographic parameters of the acromion measured in radiographs
change significantly after anterolateral acromioplasty.
Methods
This retrospective study included patients that underwent an arthroscopic anterolateral
acromioplasty between January 2014 and September 2020. n = 435 subjects with high-quality preoperative and postoperative radiographs according
to Suter-Henninger criteria were included in the final assessment. All measurements
were independently performed by the first and second author in a blinded fashion using
dicomPACS software: acromion index (AI), critical shoulder angle (CSA), lateral acromial
angle (LAA), beta angle, acromio-humeral distance (AHD), Aoki angle, frontal supraspinatus
outlet angle (FSOW), and acromion type, according to Bigliani. SPSS software was used
for statistical analysis.
Results
The beta angle and the CSA did not significantly change after operation (alpha power
0.32 and 0.11, respectively). In a subgroup analysis of patients with a pathological
CSA >35° (n = 194), the CSA changed from 38.62 (range: 35.08-47.52, SD 2.83) to 38.04 (range:
29.18-48.12, SD 3.77) postoperatively (P = .028) (Fig 8). All other parameters changed significantly after operation (AI,
AHD, FSOW, and Aoki; P = .001, LAA; P = .039) (Fig. 9). The interobserver and intraobserver reliability was good to excellent
in the majority of measured values. Mean patient age was 59.2 years (range: 18.1-87.1;
SD 11.3), mean height was 1.73 meters (range: 1,50-1.98, SD 0.09), mean weight was
80.2 kg (range: 37.0-133.0, SD 16.68), and mean body mass index was 26.6 (range: 0.0-46.1,
SD 4.73).
Conclusion
Anterolateral acromioplasty producing a flat acromion undersurface did not result
in a significant change of the CSA in the study population. Pathological preoperative
CSA values of >35° were significantly reduced but not to normal values, but only by
a small amount that puts the clinical relevance into question.
Level of Evidence
IV, diagnostic study, case series
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Article info
Publication history
Published online: June 28, 2022
Accepted:
June 8,
2022
Received:
October 23,
2021
Footnotes
See commentary on page 2969
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2022 by the Arthroscopy Association of North America
