Acromion Compromise Does Not Significantly Affect Clinical Outcomes After Reverse Shoulder Arthroplasty

A Matched Case-Control Study

Brian C. Werner, Lawrence V. Gulotta, Joshua S. Dines, David M. Dines, Russell F. Warren, Edward V Craig, Samuel A. Taylor

Research output: Contribution to journalArticle

Abstract

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). Acromion compromise was defined as (1) less than 25% of the normal acromion thickness (8.8 mm), (2) less than 50% of the normal acromion anteroposterior width (46.1 mm), (3) presence of an os acromiale, or (4) presence of acromial fragmentation. An age- and sex-matched control cohort without acromial compromise was also identified (n = 33). The primary outcome variable was the final minimum 2-year American Shoulder and Elbow Surgeons (ASES) score. Secondary outcomes included final minimum 2-year scores on the 12-Item Short-Form Health Survey (SF-12), with the physical component score (PCS) and mental component score (MCS); 2-year Marx shoulder activity scale scores; and final 2-year satisfaction scores. Results: At 2 years post-operatively, there were no significant differences in final scores using ASES, SF-12 PCS or MCS, or Marx shoulder activity scale. There were no significant differences between groups for satisfaction scores in any of the assessed domains. No complications were reported at 2 years’ follow-up in any of the study patients or controls. Conclusions: Between patients with and without pre-operative acromion compromise, there were no differences in clinical outcomes, satisfaction levels, or complication rates after RSA. Our findings suggest that surgeons performing RSA in the setting of pre-operative acromion compromise, including os acromiale, acromial fragmentation, or severe thinning, should not expect poor post-operative clinical outcomes.

Original languageEnglish (US)
Pages (from-to)147-152
Number of pages6
JournalHSS Journal
Volume15
Issue number2
DOIs
StatePublished - Jul 15 2019

Fingerprint

Acromion
Arthroplasty
Case-Control Studies
Elbow
Health Surveys

Keywords

  • ASES score
  • acromion compromise
  • os acromiale
  • patient-reported outcomes
  • reverse shoulder arthroplasty

Cite this

Acromion Compromise Does Not Significantly Affect Clinical Outcomes After Reverse Shoulder Arthroplasty : A Matched Case-Control Study. / Werner, Brian C.; Gulotta, Lawrence V.; Dines, Joshua S.; Dines, David M.; Warren, Russell F.; Craig, Edward V; Taylor, Samuel A.

In: HSS Journal, Vol. 15, No. 2, 15.07.2019, p. 147-152.

Research output: Contribution to journalArticle

Werner, Brian C. ; Gulotta, Lawrence V. ; Dines, Joshua S. ; Dines, David M. ; Warren, Russell F. ; Craig, Edward V ; Taylor, Samuel A. / Acromion Compromise Does Not Significantly Affect Clinical Outcomes After Reverse Shoulder Arthroplasty : A Matched Case-Control Study. In: HSS Journal. 2019 ; Vol. 15, No. 2. pp. 147-152.
@article{20c6f1359e5c42f3afe9ccc8d27b6424,
title = "Acromion Compromise Does Not Significantly Affect Clinical Outcomes After Reverse Shoulder Arthroplasty: A Matched Case-Control Study",
abstract = "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). Acromion compromise was defined as (1) less than 25{\%} of the normal acromion thickness (8.8 mm), (2) less than 50{\%} of the normal acromion anteroposterior width (46.1 mm), (3) presence of an os acromiale, or (4) presence of acromial fragmentation. An age- and sex-matched control cohort without acromial compromise was also identified (n = 33). The primary outcome variable was the final minimum 2-year American Shoulder and Elbow Surgeons (ASES) score. Secondary outcomes included final minimum 2-year scores on the 12-Item Short-Form Health Survey (SF-12), with the physical component score (PCS) and mental component score (MCS); 2-year Marx shoulder activity scale scores; and final 2-year satisfaction scores. Results: At 2 years post-operatively, there were no significant differences in final scores using ASES, SF-12 PCS or MCS, or Marx shoulder activity scale. There were no significant differences between groups for satisfaction scores in any of the assessed domains. No complications were reported at 2 years’ follow-up in any of the study patients or controls. Conclusions: Between patients with and without pre-operative acromion compromise, there were no differences in clinical outcomes, satisfaction levels, or complication rates after RSA. Our findings suggest that surgeons performing RSA in the setting of pre-operative acromion compromise, including os acromiale, acromial fragmentation, or severe thinning, should not expect poor post-operative clinical outcomes.",
keywords = "ASES score, acromion compromise, os acromiale, patient-reported outcomes, reverse shoulder arthroplasty",
author = "Werner, {Brian C.} and Gulotta, {Lawrence V.} and Dines, {Joshua S.} and Dines, {David M.} and Warren, {Russell F.} and Craig, {Edward V} and Taylor, {Samuel A.}",
year = "2019",
month = "7",
day = "15",
doi = "10.1007/s11420-018-9653-1",
language = "English (US)",
volume = "15",
pages = "147--152",
journal = "HSS Journal",
issn = "1556-3316",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Acromion Compromise Does Not Significantly Affect Clinical Outcomes After Reverse Shoulder Arthroplasty

T2 - A Matched Case-Control Study

AU - Werner, Brian C.

AU - Gulotta, Lawrence V.

AU - Dines, Joshua S.

AU - Dines, David M.

AU - Warren, Russell F.

AU - Craig, Edward V

AU - Taylor, Samuel A.

PY - 2019/7/15

Y1 - 2019/7/15

N2 - 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). Acromion compromise was defined as (1) less than 25% of the normal acromion thickness (8.8 mm), (2) less than 50% of the normal acromion anteroposterior width (46.1 mm), (3) presence of an os acromiale, or (4) presence of acromial fragmentation. An age- and sex-matched control cohort without acromial compromise was also identified (n = 33). The primary outcome variable was the final minimum 2-year American Shoulder and Elbow Surgeons (ASES) score. Secondary outcomes included final minimum 2-year scores on the 12-Item Short-Form Health Survey (SF-12), with the physical component score (PCS) and mental component score (MCS); 2-year Marx shoulder activity scale scores; and final 2-year satisfaction scores. Results: At 2 years post-operatively, there were no significant differences in final scores using ASES, SF-12 PCS or MCS, or Marx shoulder activity scale. There were no significant differences between groups for satisfaction scores in any of the assessed domains. No complications were reported at 2 years’ follow-up in any of the study patients or controls. Conclusions: Between patients with and without pre-operative acromion compromise, there were no differences in clinical outcomes, satisfaction levels, or complication rates after RSA. Our findings suggest that surgeons performing RSA in the setting of pre-operative acromion compromise, including os acromiale, acromial fragmentation, or severe thinning, should not expect poor post-operative clinical outcomes.

AB - 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). Acromion compromise was defined as (1) less than 25% of the normal acromion thickness (8.8 mm), (2) less than 50% of the normal acromion anteroposterior width (46.1 mm), (3) presence of an os acromiale, or (4) presence of acromial fragmentation. An age- and sex-matched control cohort without acromial compromise was also identified (n = 33). The primary outcome variable was the final minimum 2-year American Shoulder and Elbow Surgeons (ASES) score. Secondary outcomes included final minimum 2-year scores on the 12-Item Short-Form Health Survey (SF-12), with the physical component score (PCS) and mental component score (MCS); 2-year Marx shoulder activity scale scores; and final 2-year satisfaction scores. Results: At 2 years post-operatively, there were no significant differences in final scores using ASES, SF-12 PCS or MCS, or Marx shoulder activity scale. There were no significant differences between groups for satisfaction scores in any of the assessed domains. No complications were reported at 2 years’ follow-up in any of the study patients or controls. Conclusions: Between patients with and without pre-operative acromion compromise, there were no differences in clinical outcomes, satisfaction levels, or complication rates after RSA. Our findings suggest that surgeons performing RSA in the setting of pre-operative acromion compromise, including os acromiale, acromial fragmentation, or severe thinning, should not expect poor post-operative clinical outcomes.

KW - ASES score

KW - acromion compromise

KW - os acromiale

KW - patient-reported outcomes

KW - reverse shoulder arthroplasty

UR - http://www.scopus.com/inward/record.url?scp=85057519580&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057519580&partnerID=8YFLogxK

U2 - 10.1007/s11420-018-9653-1

DO - 10.1007/s11420-018-9653-1

M3 - Article

VL - 15

SP - 147

EP - 152

JO - HSS Journal

JF - HSS Journal

SN - 1556-3316

IS - 2

ER -