Analysis Of Related Factors Of Acromiohumeral Distance Change In Rotator Cuff Full-thickness Tear

Objective:To analyze the relevant factors affecting the change of acromiohumeral distance in patients with full-thickness rotator cuff tears and to investigate the correlation between acromiohumeral distance and clinical outcomes after rotator cuff repair.Methods:Retrospective analysis of 64 patients with moderate to large full-thickness rotator cuff tears admitted from June 2019 to September 2020,including 27 males and 37 females;age(42-74)years,mean(56.1 ± 6.2)years.Patients underwent preoperative and postoperative MRI and X-ray anteroposterior views of the shoulder joint,and the acromiohumeral distance was measured.Compare the difference between the acromiohumeral distance measured on MRI and the value measured on X-ray.The degree of fatty infiltration,muscle atrophy,and contracture of the tendon rupture was assessed on the basis of MRI images;and tear size was measured intraoperatively;finally,their correlation with the acromiohumeral distance on MRI was determined by correlation analysis.All patients underwent arthroscopic double-row suture bridge full-thickness repair,and postoperative follow-up was performed to assess patients’ shoulder Constant-Murley scores and analyze their correlation with acromiohumeral distance.Results:The preoperative acromiohumeral distance was 5.8 ± 2.1 mm(range1.5-10.6 mm)on the preoperative magnetic resonance images and 7.7 ± 2.3mm(range 2.1-13.1 mm)on the X-ray,and the acromiohumeral distance on the X-ray was consistently greater than the measurement on the magnetic resonance images,with a statistically significant difference(t=-4.861,P <0.001).Acromiohumeral distance was significantly negatively correlated with tear size(R=-0.836,P < 0.001);was negatively correlated with symptom duration(R=-0.715,P<0.001);was negatively correlated with fat infiltration(R=-0.623,P<0.001);was negatively correlated with the degree of tendon contracture(R=-0.572,P < 0.001);was no correlation with supraspinatus atrophy(R=0.082,P=0.518)and no correlation with age and sex(R=0.129,P=0.308;R=-0.052,P=0.683).There was no significant correlation between clinical outcome and postoperative acromiohumeral distance change(R=-0.156,P=0.219),but there was a significant positive correlation with preoperative acromiohumeral distance(R=0.846,P<0.001).Conclusion:1.The acromiohumeral distance measured using x-ray was greater than that measured on MRI;2.Acromiohumeral distance correlates with multiple factors,which helped us understand the specific mechanism of humeral head displacement;3.Clinical outcomes did not correlate with postoperative acromiohumeral distance changes and were positively correlated with preoperative acromiohumeral distance.