The Effects of Arthroscopic Lateral Acromioplasty on the Critical Shoulder Angle and the Anterolateral Deltoid Origin: An Anatomic Cadaveric Study

Authors:

J Christoph Katthagen, Daniel Cole Marchetti, Dimitri S Tahal, Travis Lee Turnbull, Peter J Millett

Abstract:

Symptomatic rotator cuff tears (RCTs) are common. Degenerative, nontraumatic RCTs result from multifactorial causes that are not fully understood. The scapular bony morphology, however, has been identified to play a major role in the formation of atraumatic RCTs. A large lateral acromion extension, as indicated by the acromion index, and an increased glenoid inclination are each associated with full-thickness RCTs. The critical shoulder angle (CSA) is a radiologic parameter that combines the measurements of inclination of the glenoid and the lateral extension of the acromion (the acromion index).6 A CSA greater than 35 is associated with RCTs, and a CSA smaller than 30 is associated with glenohumeral osteoarthritis. The “favorable” range of the CSA seems to exist between 30 and 35.

The effect a standard anterolateral acromioplasty has on the CSA is unknown, and the literature lacks potential techniques to reduce the CSA surgically. The aims of this study were therefore to investigate if (1) a standard anterolateral acromioplasty and (2) a lateral acromion resection alter the CSA without affecting the deltoid origin. It was hypothesized that a standard anterolateral acromioplasty alone would not significantly alter the CSA but an additional lateral acromion resection would and that both procedures could be executed without damaging the acromial deltoid attachment.

For the complete study: The Effects of Arthroscopic Lateral Acromioplasty on the Critical Shoulder Angle and the Anterolateral Deltoid Origin: An Anatomic Cadaveric Study

Peter Millett, MD

Average rating:

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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The Effects of Arthroscopic Lateral Acromioplasty on the Critical Shoulder Angle and the Anterolateral Deltoid Origin: An Anatomic Cadaveric Study

Authors:

Abstract:

About the Author: Peter Millett, MD