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Are Any Radiologic Parameters Independently Associated with Degenerative PSRCT -Significance of Critical Shoulder Angle.

Abstract：

BACKGROUND:Several radiologic parameters representing scapular morphology have been proposed as risk factors for degenerative posterosuperior rotator cuff tear (PSRCT). The causes of PSRCT are multifactorial; many reported risk factors are compound entities. However, no determination, made after adjustment with previously reported risk factors, of which radiologic parameters are independent risk factors for degenerative PSRCT, has been reported. Therefore, this study's purpose was to determine which radiologic parameters representing scapular morphology are independent risk factors for degenerative PSRCT in a general population, after adjustment with previously suggested risk factors. METHODS:This study involved 629 subjects (629 shoulders) drawn from a cohort of rural residents. Posterosuperior rotator cuff tear diagnoses were based on MRI findings. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for the following variables: sex, age, height, weight, waist circumference, dominant-side involvement, smoking, alcohol consumption, manual labor, diabetes, hypertension, metabolic syndrome, thyroid dysfunction, serum lipid profile, high-sensitivity C-reactive protein, and radiologic parameters. The evaluated radiologic parameters were the superior displacement of the humeral head (SDHH) and those representing the scapular morphology. The radiologic parameters representing the scapular morphology were lateral acromial angle, acromial slope, acromial tilt, acromial index, and critical shoulder angle (CSA). Univariate logistic regression analyses for all variables, as well as multivariable logistic regression analyses for variables with significant associations and clinical effect sizes in the univariate logistic regression analyses, were performed. In order to determine the cutoff value for significant radiologic parameters, each pair of candidate cutoff values was obtained as follows: one candidate, as the lowest significant ordinal value in a univariate analysis, and the other candidate, according to an ROC curve analysis. Then, the cutoff values were determined by selecting the value in each candidate pair which had the larger area under the receiver operating characteristic curve (AUC), using the DeLong test. RESULTS:In the multivariable analyses, CSA was significantly associated with degenerative PSRCT, after controlling for the following factors: age, waist circumference, dominant-side involvement, manual labor, diabetes, metabolic syndrome, hypo-high-density lipoproteinemia, and SDHH (P ≤ .033). CSA (OR, 1.58 [95% CI, 1.45-1.72]; P < .001) was the only significantly associated radiologic parameter among the studied radiologic parameters representing scapular morphology. CONCLUSION:CSA (≥35°) is an independent associated factor for degenerative PSRCT, after adjustment for the following suggested risk factors: age, waist circumference, dominant-side involvement, manual labor, diabetes, metabolic syndrome, hypo-high-density lipoproteinemia, and SDHH. LEVEL OF EVIDENCE:Level III, Retrospective Cohort Comparison; Prognosis Study.

journal_name

J Shoulder Elbow Surg

journal_title

Journal of shoulder and elbow surgery

authors

Park HB,Gwark JY,Kwack BH,Na JB

doi

10.1016/j.jse.2020.10.004

subject

Has Abstract

pub_date

2020-11-13 00:00:00

eissn

1058-2746

issn

1532-6500

pii

S1058-2746(20)30853-3

pub_type

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Are Any Radiologic Parameters Independently Associated with Degenerative PSRCT -Significance of Critical Shoulder Angle.