2023, Vol. 27 ›› Issue (31): 5040-5045

Correlation of acromial index and acromiohumeral distance with age in middle-aged and elderly patients with degenerative rotator cuff tear

Shen Yong, Liu Shizhang, Zhai Tengfei, Hou Shuanghu, Feng Min   

Abstract: BACKGROUND: Degenerative rotator cuff tear is one of the main diseases affecting shoulder joint activities. In clinical work, the number of middle-aged patients has increased significantly and measurements of acromial index and acromiohumeral distance can be completed in shoulder X-ray examinations, both of which are clearly expressed as direct risk factors for rotator cuff injury. Abnormalities in these two indexes indicate impingement, injury, and tear of the rotator cuff are aggravated in different directions during shoulder joint activities (especially abduction and lift). Whether there is a difference between the two indicators of middle-aged patients and elderly patients and whether there is a correlation between the two indicators and the patient’s age remain to be further confirmed.
OBJECTIVE: To analyze whether there is a difference between the acromion index and acromiohumeral distance between middle-aged and elderly patients with degenerative rotator cuff tear, and to analyze whether the two indicators are correlated with the patient’s age.
METHODS: A total of 64 patients diagnosed with degenerative rotator cuff tear and 63 patients with no non-rotator cuff tear were enrolled, who were admitted at Department of Orthopedics of Shaanxi Provincial People’s Hospital from April 2019 to June 2022. Receiver curve analysis was used to determine acromion index, cut-off value of acromiohumeral distance and area under the curve. Then, enrolled patients were divided into four groups according to age and whether or not rotator cuff tear existed: middle-aged tear group, middle-aged control group, elderly tear group, and elderly control group. We compared acromion index and acromiohumeral distance between groups and investigated the correlation between the two indicators and the age of the patients.
RESULTS AND CONCLUSION: (1) The area under the curve of the acromion index and the acromiohumeral distance was 0.710 and 0.706, respectively. The cut-off values were > 0.70 for the acromion index and < 7.9 mm for the acromiohumeral distance. (2) The acromion index in the middle-aged tear group was significantly higher than that in the middle-aged control group (P=0.013), while the acromiohumeral distance was significantly smaller than that in the middle-aged control group (P < 0.001). The acromion index in the elderly tear group was significantly higher than that in the elderly control group (P < 0.001), but there was no significant difference in the acromiohumeral distance between the two groups (P > 0.05). There was no significant difference in the acromion index between the middle-aged and elderly tear groups (P > 0.05); however, the acromiohumeral distance was significantly lower in the middle-aged tear group than that in the elderly tear group (P < 0.001). (3) There was no negative correlation between the acromion index and age (r=-0.015, P=0.83) and was a positive correlation between the acromiohumeral distance and age (r=0.334, P < 0.001). (4) To conclude, the acromion index and acromiohumeral distance are both risk factors for degenerative rotator cuff tear. The middle-aged patients with rotator cuff tear have abnormal acromial index and acromiohumeral distance compared with the middle-aged control group. There is a positive correlation between the acromiohumeral distance and age in patients with rotator cuff tears.

Key words: degenerative rotator cuff tear, acromial index, acromiohumeral distance, supraspinatus, subacromial impingement