JD Craik, R Malina, V Ramasamay & NJ Little. Subacromial Impingement & Rotator Cuff Tears 44% to 65% of all shoulder complaints Two main theories: Mechanical.

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Presentation transcript:

JD Craik, R Malina, V Ramasamay & NJ Little

Subacromial Impingement & Rotator Cuff Tears 44% to 65% of all shoulder complaints Two main theories: Mechanical (extrinsic) theory Degenerative (intrinsic) theory

Anatomical Risk Factors Type I Type II Type III Bigliani Classification

Anatomical Risk Factors AH Coracoacromial Arch Height

Anatomical Risk Factors AVP Acromion Ventral Projection

Anatomical Risk Factors AT Acromion Tilt

Acromioglenoid Angle AGA Anatomical Risk Factors

CGA Coracoglenoid Angle Anatomical Risk Factors

ALP Acromion Lateral Projection Anatomical Risk Factors

CLP Coracoid Lateral Projection Anatomical Risk Factors

GV Anatomical Risk Factors Glenoid Version

GI Glenoid Inclination Anatomical Risk Factors

14 Mya 7 Mya 6 Mya

Anatomical risk factors unique or accentuated in human scapulae may play a more direct role in subacromial impingement and rotator cuff tear aetiology. Hypothesis

Methods

Dry Bone Scapulae 22 human 17 gorilla 13 chimpanzee 12 orangutan Methods

Fiji Image J Software Microsoft Excel (Mac 2008)

Methods VBL Vertebral Border Length

Methods Supraspinatus Area Infraspinatus Area

Results Bigliani Classification Type I Type II Type III Bigliani Type I / II / III0 / 8 / 41 / 11 / 14 / 13 / 03 / 17 / 2

Results Coracoacromial Arch Height Increased Risk mm

Results Acromion Ventral Projection Increased Risk mm

Results Acromion Tilt Increased Risk Degrees

Results Acromioglenoid Angle Increased Risk Degrees

Results Coracoglenoid Angle Increased Risk Degrees

Results Acromion Lateral Projection Increased Risk mm

Results Coracoid Lateral Projection Increased Risk mm

Results Glenoid Version Increased Risk Degrees

Results Glenoid Inclination Increased Risk Degrees

These anatomical risk factors are not unique to humans! The extrinsic theory is not supported by these results as a primary aetiological factor Therefore:

Results Fossa Ratio???

This study aimed to determine if any of the risk factors associated with impingement and rotator cuff tears are accentuated in humans The extrinsic theory is not supported by these results as a primary aetiological factor Reduction in Supraspinatus Fossa Size Muscle / tendon insufficiency ? Force vector shift ? Conclusions

Thank You