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The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints

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Abstract
Introduction Although degenerative osteoarthritis of the acromioclavicular joint is a common finding on technical investigations, not every patient experiences pain or function loss. The difference between symptomatic and asymptomatic patients is currently not elucidated. Therefore, we want to investigate the acromioclavicular relationship in normal, asymptomatic, and symptomatic degenerated ACJ. Materials and methods 84 normal ACJ, 39 asymptomatic degenerated ACJ, and 30 symptomatic degenerated ACJ were 3D reconstructed. The morphological dimensions and the relationship of the acromion and distal clavicle were measured using computational software. The reproducibility of this technique was evaluated using inter- and intra-observer reliability. Results The mean anteroposterior and superoinferior distance of both the clavicle and acromion was significantly larger in asymptomatic and symptomatic degenerative ACJ compared to the normal ACJ (p < 0.001). In symptomatic osteoarthritic ACJ, both the anterior and posterior borders of the acromion were significantly more anterior to the borders of the clavicle than in the normal group and asymptomatic group (p < 0.001). Subsequent ROC curve analysis resulted in a sensitivity of 86.7% and a specificity of 88.6% for anterior subluxation of the ACJ. This technique showed an excellent inter- and intra-observer reliability. Conclusions In patients with degenerative ACJ, both the distal clavicle and acromion are enlarged. In asymptomatic patients, the AC relationship is the same as in normal patients, in contrast, in patients with symptomatic degenerative ACJ, the acromion is subluxated anteriorly compared to the clavicle.
Keywords
Surgery, Orthopedics and Sports Medicine, General Medicine, Acromioclavicular morphology, 3D CT reconstruction, Acromioclavicular relationship, Osteoarthritis, AC joint, Three-dimensional study, TRAPEZIAL DYSPLASIA, ROTATOR CUFF, ARTHRITIS, OSTEOTOMY, RESECTION

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MLA
Bulkmans, Kristof, et al. “The Relationship of the Acromion to the Distal Clavicle in Normal and Symptomatic Degenerated Acromioclavicular Joints.” ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, vol. 140, no. 4, 2020, pp. 465–72, doi:10.1007/s00402-019-03258-9.
APA
Bulkmans, K., Peeters, I., De Wilde, L., & Van Tongel, A. (2020). The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 140(4), 465–472. https://doi.org/10.1007/s00402-019-03258-9
Chicago author-date
Bulkmans, Kristof, Ian Peeters, Lieven De Wilde, and Alexander Van Tongel. 2020. “The Relationship of the Acromion to the Distal Clavicle in Normal and Symptomatic Degenerated Acromioclavicular Joints.” ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 140 (4): 465–72. https://doi.org/10.1007/s00402-019-03258-9.
Chicago author-date (all authors)
Bulkmans, Kristof, Ian Peeters, Lieven De Wilde, and Alexander Van Tongel. 2020. “The Relationship of the Acromion to the Distal Clavicle in Normal and Symptomatic Degenerated Acromioclavicular Joints.” ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 140 (4): 465–472. doi:10.1007/s00402-019-03258-9.
Vancouver
1.
Bulkmans K, Peeters I, De Wilde L, Van Tongel A. The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY. 2020;140(4):465–72.
IEEE
[1]
K. Bulkmans, I. Peeters, L. De Wilde, and A. Van Tongel, “The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints,” ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, vol. 140, no. 4, pp. 465–472, 2020.
@article{8627178,
  abstract     = {Introduction Although degenerative osteoarthritis of the acromioclavicular joint is a common finding on technical investigations, not every patient experiences pain or function loss. The difference between symptomatic and asymptomatic patients is currently not elucidated. Therefore, we want to investigate the acromioclavicular relationship in normal, asymptomatic, and symptomatic degenerated ACJ. Materials and methods 84 normal ACJ, 39 asymptomatic degenerated ACJ, and 30 symptomatic degenerated ACJ were 3D reconstructed. The morphological dimensions and the relationship of the acromion and distal clavicle were measured using computational software. The reproducibility of this technique was evaluated using inter- and intra-observer reliability. Results The mean anteroposterior and superoinferior distance of both the clavicle and acromion was significantly larger in asymptomatic and symptomatic degenerative ACJ compared to the normal ACJ (p < 0.001). In symptomatic osteoarthritic ACJ, both the anterior and posterior borders of the acromion were significantly more anterior to the borders of the clavicle than in the normal group and asymptomatic group (p < 0.001). Subsequent ROC curve analysis resulted in a sensitivity of 86.7% and a specificity of 88.6% for anterior subluxation of the ACJ. This technique showed an excellent inter- and intra-observer reliability. Conclusions In patients with degenerative ACJ, both the distal clavicle and acromion are enlarged. In asymptomatic patients, the AC relationship is the same as in normal patients, in contrast, in patients with symptomatic degenerative ACJ, the acromion is subluxated anteriorly compared to the clavicle.},
  author       = {Bulkmans, Kristof and Peeters, Ian and De Wilde, Lieven and Van Tongel, Alexander},
  issn         = {0936-8051},
  journal      = {ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY},
  keywords     = {Surgery,Orthopedics and Sports Medicine,General Medicine,Acromioclavicular morphology,3D CT reconstruction,Acromioclavicular relationship,Osteoarthritis,AC joint,Three-dimensional study,TRAPEZIAL DYSPLASIA,ROTATOR CUFF,ARTHRITIS,OSTEOTOMY,RESECTION},
  language     = {eng},
  number       = {4},
  pages        = {465--472},
  title        = {The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints},
  url          = {http://dx.doi.org/10.1007/s00402-019-03258-9},
  volume       = {140},
  year         = {2020},
}

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