Association Between Acromial Index and Outcomes Following Arthroscopic Repair of Full-Thickness Rotator Cuff Tears

Authors:

James B Ames, Marilee P Horan, Olivier A J Van der Meijden, Melissa J Leake, Peter J Millett

Abstract:

The pathogenesis of rotator cuff disease remains controversial, with several intrinsic (genetic) and extrinsic (anatomical) causes suggested as possible contributing factors. The theory of extrinsic compression leading to rotator cuff disease was first proposed by Neer. Proposed extrinsic factors in the development of rotator cuff disease include the morphology of the anterior acromion, the lateral acromial angle, the coracohumeral interval, the internal impingement of the posterior rotator cuff on the posterosuperior border of the glenoid, and the glenoid version. Intrinsic factors associated with rotator cuff tears, encompassing mechanisms occurring within the rotator cuff itself and first proposed by Codman in 1934, include tissue degeneration, alterations in metabolism, and oxidative stress-related change.

Many prognostic factors affecting outcomes following full-thickness rotator cuff repairs have been reported. Predictors of poor outcomes include age, tear size, tear chronicity, and fatty infiltration and atrophy of the torn rotator cuff muscle.

Recently, an association among the lateral extension of the acromion, the acromial index, and rotator cuff disease has been described. It has been reported that in open rotator cuff repair, a large acromial index is associated with an increased risk of retearing. Combined with the findings of several studies that have shown better subjective and objective results of rotator cuff repair when the tendon has been documented to heal, these results have led to a perception that a large acromial index may be a poor prognostic factor following surgical repair of a torn rotator cuff. We recognize that most rotator cuff tears are now repaired arthroscopically. Therefore, we elected to study this relationship in greater detail in arthroscopic rotator cuff repairs.

The objective of the present study was to evaluate the association between acromial index size and rotator cuff tears and to determine if an increasing acromial index is associated with poor outcomes after arthroscopic full-thickness rotator cuff repairs. Our hypotheses were that a large acromial index would have an association with full-thickness rotator cuff tear repair and it would have a negative association with short to intermediate-term outcomes following arthroscopic rotator cuff repair.

For the complete study: Association Between Acromial Index and Outcomes Following Arthroscopic Repair of Full-Thickness Rotator Cuff Tears

Peter Millett, MD

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39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!

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Association Between Acromial Index and Outcomes Following Arthroscopic Repair of Full-Thickness Rotator Cuff Tears

Authors:

Abstract:

About the Author: Peter Millett, MD