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The influence of critical shoulder angle on secondary rotator cuff insufficiency following shoulder arthroplasty

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Secondary cuff failure after shoulder replacement is disabling and often requires additional surgery. Increased critical shoulder angle (CSA) has been found in patients with cuff tear compared to normal subjects. The interobserver reliability of the CSA and the relationship between CSA and symptomatic secondary cuff failure after shoulder replacement were investigated.

Materials and methods

Nineteen patients with symptomatic cuff failure after anatomic shoulder replacement (mean FU 45 months) were compared to a control group of 29 patients showing no signs of symptomatic cuff failure (mean FU 105.7 months). The CSA was measured by two blinded surgeons at a mean follow-up of 45 and 105.7 months, respectively. Inter-observer reliability was calculated.

Results

The mean CSA in the study group in neutral, internal and external rotations were 33°, 34° and 34°, respectively. Corresponding values in the control group were 32°, 32° and 32°. The interclass correlation coefficient for the whole population between the two examiners were 0.956 (P < 0.01), 0.964 (P < 0.01) and 0.955 (P < 0.01), respectively.

Conclusion

There were no significant differences of CSA values between patients who had undergone shoulder replacement and experienced late cuff failure and those in whom the same procedure had been successful. A good inter-observer reliability was found for the CSA method.

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Authors and Affiliations

  1. Casa di Cura Villa Betania, Via Piccolomini 27, 00165, Rome, Italy

    Simone Cerciello

  2. Marrelli Hospital, via Gioacchino da Fiore 0962, Crotone, Italy

    Simone Cerciello

  3. NDORMS, University of Oxford, Oxford, UK

    Andrew Paul Monk

  4. Ospedali Riuniti Padova Sud-ULSS 17, Schiavonia, PD, Italy

    Enrico Visonà

  5. Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy

    Stefano Carbone

  6. Fondren Orthopaedic Group, Texas Orthopaedic Hospital, Houston, USA

    Thomas Bradley Edwards

  7. Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy

    Nicola Maffulli

  8. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK

    Nicola Maffulli

  9. Centre Orthopédique Santy, Lyon, France

    Gilles Walch

  10. Via R. Zandonai 11, 00135, Rome, Italy

    Simone Cerciello

Authors
  1. Simone Cerciello
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  2. Andrew Paul Monk
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  3. Enrico Visonà
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  4. Stefano Carbone
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  6. Nicola Maffulli
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  7. Gilles Walch
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Correspondence to Simone Cerciello.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Cerciello, S., Monk, A.P., Visonà, E. et al. The influence of critical shoulder angle on secondary rotator cuff insufficiency following shoulder arthroplasty. Arch Orthop Trauma Surg 137, 913–918 (2017). https://doi.org/10.1007/s00402-017-2707-x

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  • DOI: https://doi.org/10.1007/s00402-017-2707-x

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