A predictive model for the critical shoulder angle based on a three-dimensional analysis of scapular angular and linear morphometrics.
Acromial morphology
Acromioplasty
Critical shoulder angle
Glenoid inclination
Rotator cuff tear
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
22 Nov 2022
22 Nov 2022
Historique:
received:
24
05
2022
accepted:
26
10
2022
entrez:
24
11
2022
pubmed:
25
11
2022
medline:
26
11
2022
Statut:
epublish
Résumé
The purpose of this study was to define the features of scapular morphology that are associated with changes in the critical shoulder angle (CSA) by developing the best predictive model for the CSA based on multiple potential explanatory variables, using a completely 3D assessment. 3D meshes were created from CT DICOMs using InVesalius (Vers 3.1.1, RTI [Renato Archer Information Technology Centre], Brazil) and Meshmixer (3.4.35, Autodesk Inc., San Rafael, CA). The analysis included 17 potential angular, weighted linear and area measurements. The correlation of the explanatory variables with the CSA was investigated with the Pearson's correlation coefficient. Using multivariable linear regression, the approach for predictive model-building was leave-one-out cross-validation and best subset selection. Fifty-three meshes were analysed. Glenoid inclination (GI) and coronal plane angulation of the acromion (CPAA) [Pearson's r: 0.535; -0.502] correlated best with CSA. The best model (adjusted R-squared value 0.67) for CSA prediction contained 10 explanatory variables including glenoid, scapular spine and acromial factors. CPAA and GI were the most important based on their distribution, estimate of coefficients and loss in predictive power if removed. The relationship between scapular morphology and CSA is more complex than the concept of it being dictated solely by GI and acromial horizontal offset and includes glenoid, scapular spine and acromial factors of which CPAA and GI are most important. A further investigation in a closely defined cohort with rotator cuff tears is required before drawing any clinical conclusions about the role of surgical modification of scapular morphology. Level 4 retrospective observational cohort study with no comparison group.
Sections du résumé
BACKGROUND
BACKGROUND
The purpose of this study was to define the features of scapular morphology that are associated with changes in the critical shoulder angle (CSA) by developing the best predictive model for the CSA based on multiple potential explanatory variables, using a completely 3D assessment.
METHODS
METHODS
3D meshes were created from CT DICOMs using InVesalius (Vers 3.1.1, RTI [Renato Archer Information Technology Centre], Brazil) and Meshmixer (3.4.35, Autodesk Inc., San Rafael, CA). The analysis included 17 potential angular, weighted linear and area measurements. The correlation of the explanatory variables with the CSA was investigated with the Pearson's correlation coefficient. Using multivariable linear regression, the approach for predictive model-building was leave-one-out cross-validation and best subset selection.
RESULTS
RESULTS
Fifty-three meshes were analysed. Glenoid inclination (GI) and coronal plane angulation of the acromion (CPAA) [Pearson's r: 0.535; -0.502] correlated best with CSA. The best model (adjusted R-squared value 0.67) for CSA prediction contained 10 explanatory variables including glenoid, scapular spine and acromial factors. CPAA and GI were the most important based on their distribution, estimate of coefficients and loss in predictive power if removed.
CONCLUSIONS
CONCLUSIONS
The relationship between scapular morphology and CSA is more complex than the concept of it being dictated solely by GI and acromial horizontal offset and includes glenoid, scapular spine and acromial factors of which CPAA and GI are most important. A further investigation in a closely defined cohort with rotator cuff tears is required before drawing any clinical conclusions about the role of surgical modification of scapular morphology.
LEVEL OF EVIDENCE
METHODS
Level 4 retrospective observational cohort study with no comparison group.
Identifiants
pubmed: 36419105
doi: 10.1186/s12891-022-05920-7
pii: 10.1186/s12891-022-05920-7
pmc: PMC9685918
doi:
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1006Informations de copyright
© 2022. The Author(s).
Références
J Shoulder Elbow Surg. 2018 Sep;27(9):1602-1606
pubmed: 29731396
Bone Res. 2017 Jan 17;5:16044
pubmed: 28149655
Knee Surg Sports Traumatol Arthrosc. 2016 Jul;24(7):2244-51
pubmed: 25820655
J Bone Joint Surg Am. 1992 Aug;74(7):1032-7
pubmed: 1522089
J Shoulder Elbow Surg. 2016 Mar;25(3):413-21
pubmed: 26652696
J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):874-85
pubmed: 19482489
J Shoulder Elbow Surg. 2017 Dec;26(12):2097-2102
pubmed: 28739300
J Shoulder Elbow Surg. 2018 Jan;27(1):151-159
pubmed: 29111197
J Shoulder Elbow Surg. 2007 May-Jun;16(3):347-51
pubmed: 17113323
J Shoulder Elbow Surg. 2018 Dec;27(12):2224-2231
pubmed: 30100175
J Shoulder Elbow Surg. 2014 Apr;23(4):536-41
pubmed: 24480324
J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499017690317
pubmed: 28215115
J Shoulder Elbow Surg. 1995 Nov-Dec;4(6):454-61
pubmed: 8665291
Clin Orthop Relat Res. 2003 Feb;(407):86-91
pubmed: 12567135
Knee Surg Sports Traumatol Arthrosc. 2016 Jul;24(7):2200-5
pubmed: 25547273
Arthroscopy. 2016 Apr;32(4):569-75
pubmed: 26895784
Arthroscopy. 2018 Mar;34(3):771-780
pubmed: 29100767
Arthroscopy. 2019 Dec;35(12):3304-3315.e2
pubmed: 31785763
J Shoulder Elbow Surg. 2021 May;30(5):1095-1106
pubmed: 32822879
Surg Radiol Anat. 2012 Jul;34(5):447-53
pubmed: 22271163
Arthroscopy. 2020 Feb;36(2):566-575
pubmed: 31901393
J Shoulder Elbow Surg. 2016 Aug;25(8):1328-36
pubmed: 26899036
Clin Orthop Relat Res. 2003 Oct;(415):111-20
pubmed: 14612637
J Orthop Res. 2014 Jul;32(7):952-7
pubmed: 24700399
Clin Anat. 2020 Oct;33(7):1069-1074
pubmed: 31883136
J Shoulder Elbow Surg. 2015 Jun;24(6):e149-58
pubmed: 25591458
Clin Biomech (Bristol, Avon). 2020 Aug;78:105091
pubmed: 32580097
J Shoulder Elbow Surg. 2015 Nov;24(11):1834-43
pubmed: 26209913
J Shoulder Elbow Surg. 2018 Oct;27(10):1866-1876
pubmed: 29752153
Arthroscopy. 2017 Mar;33(3):511-517
pubmed: 27815011
Arch Orthop Trauma Surg. 2016 Jun;136(6):799-804
pubmed: 26920400
J Shoulder Elbow Surg. 2017 Jun;26(6):1103-1112
pubmed: 28162885
J Shoulder Elbow Surg. 2021 Sep;30(9):e558-e571
pubmed: 33600897
Clin Biomech (Bristol, Avon). 2020 Feb;72:115-121
pubmed: 31862605
J Orthop Res. 2016 Jun;34(6):961-8
pubmed: 26572231
Arthrosc Sports Med Rehabil. 2020 Sep 03;2(5):e547-e552
pubmed: 33134993
Rev Bras Ortop. 2017 Jun 15;52(4):423-427
pubmed: 28884100
J Orthop Surg (Hong Kong). 2017 Sep-Dec;25(3):2309499017727950
pubmed: 28905690
J Bone Joint Surg Am. 2006 Apr;88(4):800-5
pubmed: 16595470
J Orthop Res. 2016 Jun;34(6):1047-52
pubmed: 26638117
J Shoulder Elbow Surg. 1995 Nov-Dec;4(6):441-8
pubmed: 8665289
J Shoulder Elbow Surg. 2012 Aug;21(8):1096-103
pubmed: 22036540
Bone Joint J. 2013 Jul;95-B(7):935-41
pubmed: 23814246
Acta Orthop. 2013 Apr;84(2):178-83
pubmed: 23409811
J Shoulder Elbow Surg. 2010 Jan;19(1):116-20
pubmed: 19540777
J Shoulder Elbow Surg. 2001 Jul-Aug;10(4):327-32
pubmed: 11517362
Orthop Traumatol Surg Res. 2016 Sep;102(5):559-62
pubmed: 27238292